Ashville Surgery

Updated 19 January 2018

Ashville Surgery is based in Chorlton, Manchester and is part of the NHS Central Manchester Clinical Commissioning Group (CCG) and has 9397 patients. The area has a diverse ethnicity of patients and the practice provides service under a General Medical Services contract.

Information published by Public Health England rates the level of deprivation within the practice population group as four on a scale of one to 10. Level one represents the highest levels of deprivation and level 10 the lowest. Male and female life expectancy in the practice geographical area is 79.4 years for males and 83.1 years for females. The numbers of patients in the different age groups on the GP practice register were generally similar to the average GP practice in England.

The service is provided by three GP partners and five salaried GPs. The practice also employs a practice manager, three nursing staff (including a healthcare assistant and two nurses) as well as a number of reception /administrative staff who also cover other duties such as dealing with samples and drafting prescriptions. The practice also works with specialist trainees and medical students. The practice is based in an older building with ramp access to the lower ground floor only for people with mobility problems. There is plenty of parking including a specific parking bay for people with disabilities. The practice has a number of consulting and treatment rooms used by the GPs and nursing staff as well as visiting professionals such as health visitors.

The practice is open Mondays, Wednesdays and Fridays from 8am to 6:30pm, Tuesdays and Thursdays from 8am to 8pm. In addition to pre-bookable appointments that can be booked up to three months in advance, urgent appointments are also available for people that need them such as young children or the elderly. Out of hours cover is provided by the NHS 111 service. Online appointments and telephone consultation services are also available.

Updated 19 January 2018

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Ashville Surgery on 14 January 2016. The overall rating for the practice was good, with a requires improvement rating for the key question of safe and we issued a requirement notice for breaches of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Safe care and treatment). The full comprehensive report on the January 2016 inspection can be found by selecting the ‘all reports’ link for Ashville Surgery on our website at www.cqc.org.uk.

This inspection was a desk-based review carried out on 26 November  2017 to confirm that the practice had carried out their plan to meet the legal requirements in relation to the breaches identified in the requirement notice.

Overall the practice is now rated as good, with the previous rating of requires improvement for the key question of safe updated to a rating of good.

Our key findings were as follows:

• The practice was able to demonstrate that they had considered risks and identified mitigating actions in a number of areas.

• Systems were in place to monitor the use of prescription paper

However, there was an area of practice where the provider should make improvements.

The provider should:

• Consider current guidance from the Resuscitation Council (UK) as part of their risk assessment and rationale for no defibrillator on site.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 February 2016

The practice is rated as good for the care of people with long-term conditions.

• Nursing staff had lead roles in chronic disease management and patients at risk of hospital admission were identified as a priority.
• Performance for diabetes related indicators was better than the national average for all five indicators (2014/15). The percentage of patients with diabetes, on the register, in whom the last IFCCHbA1c is 64 mmol/mol or less in the preceding 12 months (01/04/2014 to 31/03/2015), was 87.2%, above the England average at 77.54%. The percentage of patients with diabetes, on the register, in whom the last blood pressure reading (measured in the preceding 12 months) was 140/80 mmHg or less (01/04/2014 to 31/03/2015) was 81.15% which was above the England average of 78.03%. The percentage of patients with diabetes, on the register, who had influenza immunisation in the preceding 1 August to 31 March (01/04/2014 to 31/03/2015), was 97.72% with the England average at 94.45%. The percentage of patients with diabetes, on the register, whose last measured total cholesterol (measured within the preceding 12 months) was 5 mmol/l or less (01/04/2014 to 31/03/2015) was 84.29% with the England average at 80.53%. The percentage of patients on the diabetes register, with a record of a foot examination and risk classification within the preceding 12 months (01/04/2014 to 31/03/2015) was 91.47% with the England average at 88.3%.
• Longer appointments and home visits were available when needed.
• All these patients had a named GP and a structured annual review to check their health and medicines needs were being met. For those patients with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 18 February 2016

The practice is rated as good for the care of families, children and young people.

• There were systems in place to identify and follow up children living in disadvantaged circumstances and who were at risk, for example, children and young people who had a high number of A&E attendances.
• Childhood immunisation rates for the vaccinations given were comparable to CCG/national averages (01/04/2014 to 31/03/2015). For example, childhood immunisation rates for the vaccinations given to under two year olds ranged from 51.5% to 93.4% and five year olds from 36.7% to 95.4%.
• The percentage of patients with asthma, on the register, who have had an asthma review in the preceding 12 months that includes an assessment of asthma control using the three RCP questions (01/04/2014 to 31/03/2015) was above the England average of 70.81% at 77.84%.
• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals, and we saw evidence to confirm this.
• The practice’s uptake for the cervical screening programme was 72.2% (March 2015), which was higher than the CCG average of 65.4% and comparable to the national average of 74.3%. The staff told us this was due to 50% of the local population being from black and minority ethnic (BME) communities who had difficulty in understanding some concepts in relation to cervical and cancer screening.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• We saw positive examples of joint working with midwives, health visitors and school nurses.

Updated 18 February 2016

The practice is rated as good for the care of older people.

• The practice offered proactive, personalised care to meet the needs of the older people in its population.
• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

Updated 18 February 2016

The practice is rated as good for the care of working-age people (including those recently retired and students).

• The needs of the working age population, those recently retired and students had been identified and the practice had adjusted the services it offered to ensure these were accessible, flexible and offered continuity of care.
• The practice was proactive in offering online services as well as a full range of health promotion and screening that reflects the needs for this age group.

Updated 18 February 2016

The practice is rated as good for the care of people experiencing poor mental health (including people with dementia).

• 91.8% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months (01/04/2014 to 31/03/2015), which was above to the national average (84.01%).
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses who had a comprehensive, agreed care plan documented in the record, in the preceding 12 months (01/04/2014 to 31/03/2015) was 90.6%, which was above the England average of 88.47%.
• The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses whose alcohol consumption had been recorded in the preceding 12 months (01/04/2014 to 31/03/2015) was 93.65%, which was above the England average of 89.55%.
• The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health, including those with dementia.
• The practice carried out advance care planning for patients with dementia.
• The practice had told patients experiencing poor mental health about how to access various support groups and voluntary organisations.
• The practice had a system in place to follow up patients who had attended accident and emergency where they may have been experiencing poor mental health.
• Staff had a good understanding of how to support patients with mental health needs and dementia.

Updated 18 February 2016

The practice is rated as good for the care of people whose circumstances may make them vulnerable.

• The practice held a register of patients living in vulnerable circumstances including homeless people, travellers and those with a learning disability.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• The practice informed vulnerable patients about how to access various support groups and voluntary organisations.
• Staff knew how to recognise signs of abuse in vulnerable adults and children. Staff were aware of their responsibilities regarding information sharing, documentation of safeguarding concerns and how to contact relevant agencies in normal working hours and out of hours.