Archived: Salford Health Matters Eccles

Letter from the Chief Inspector of General Practice

This is the report of findings from our inspection of Salford Health Matters Eccles. The practice is registered with the Care Quality Commission to provide primary care services.

We carried out a comprehensive inspection on 3 October 2014. We spoke with patients, members of the patient participation group (PPG), and staff including the management team.

The practice is rated as Outstanding. An effective, responsive and well-led service is provided that meets the needs of the population it serves.

All regulated activities provided by Salford Health Matters Eccles were inspected.

Our key findings are as follows:

• The service is safe.  Staff understand and fulfil their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents are maximised to support improvement.
• The service is effective. The practice is using innovative and proactive methods to improve patient outcomes and it links with other local providers to share best practice. It is involved in a local scheme where a holistic approach to health and social care is being trialled.
• The practice is caring. Feedback from patients about their care and treatment is consistently and strongly positive. There is a patient centred culture and strong evidence that staff are motivated and inspired to offer kind and compassionate care, working to overcome obstacles to achieve this. There are many positive examples to demonstrate how people’s choices and preferences are valued and acted on.
• The practice is responsive to people’s needs. The practice implements suggestions for improvements and makes changes to the way it delivers services as a consequence of feedback directly from patients and from the patient participation group (PPG).
• The practice is well-led.  They have clear vision which has quality and safety as its top priority. A business plan is in place that is monitored and regularly reviewed by the board, and discussed with all staff. The practice is a social enterprise and has a board of directors, including a non-clinical chief executive, responsible for making business decisions. High standards are promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice including:

• All patients who require an appointment with a GP are seen on the day their request is made. Requests can be made at any time of the day, and the practice has late night and weekend opening so patients not available during working hours can access appointments easily.
• Appointment length is need-specific so GPs arrange longer appointments when they think this is necessary. Longer appointments are routinely offered to some patients, for example patients with a learning disability.
• Patients have the facility to attend another practice within the group that has different late night or a different Saturday opening if this is more convenient for them.
• As well as discussing significant events with staff, they are discussed with people outside the practice so that ideas for improvement can be shared. 
• The practice has a very good skills mix which includes advanced nurse practitioners (ANPs). The ANPs are able to have more responsibility than practice nurses and see a broader range of patients. There is a preceptorship programme in place to support new ANPs to the practice. There is an excellent system for completing and learning from clinical audit cycles, and learning is shared within the practice and with external organisations.
• The practice takes the care of vulnerable people seriously. A GP from the practice attends a drop-in centre three times a week and homeless patients have access to that GP without an appointment. All patients can access the practice for appointments if they prefer.
• The practice takes the care of people with dementia seriously. All staff are 'dementia friends', so know more about how they can help people with the condition.
• The practice proactively looks for feedback from patients and sends a text message to all patients following an appointment to ask one question about their satisfaction. They contact patients who are not satisfied to discuss areas for improvement.
• The business plan is discussed and monitored by the board. At any given time detailed information about the performance of all areas of the practice is available.
• Communication with staff is excellent. Weekly meetings away from the workplace take place and staff receive weekly email correspondence from the chief executive informing them of any relevant information.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice