Background to this inspection
Updated
21 November 2019
Ashfield Medical Centre, also known as Dr Cassidy and Partners provides a range of primary medical services, including minor surgical procedures, from its location at Perrydown, Beanhill in Milton Keynes. It serves patients who live in the Beanhill, Netherfield and Coffee Hall areas of Milton Keynes. It is part of the NHS Milton Keynes Clinical Commissioning Group (CCG). The practice holds a General Medical Services (GMS) contract for providing services, which is a nationally agreed contract between general practices and NHS England for delivering general medical services to local communities.
The practice serves a population of approximately 11,250 patients with slightly higher than average populations of males and females aged 0 to 18 years. There are slightly lower than national average populations of patients aged over 65 years. The practice population is largely White British, with 30% of the practice population being from Black and Minority Ethnicity backgrounds.
Information published by Public Health England, rates the level of deprivation within the practice population group as two on a scale of one to 10. Level one represents the highest levels of deprivation and level 10 the lowest.
The clinical team consists of three male GP partners, a female GP partner, two advanced nurse practitioners (female), two practice nurses (female) and two health care assistants (both female). The team is supported by a practice manager and a team of non-clinical, administrative staff. Members of the community midwife and health visiting team also operate regular clinics from the practice location. The practice is a teaching practice and accepts FY2 doctors every four months. FY2 doctors are qualified doctors in their second year of foundation training, the completion of which allows them to apply for further study and training in a specialised area of medicine. At the time of our inspection there was one FY2 doctor in situ.
The practice is part of a Primary Care Network (PCN)with five other practices. The PCN have access to an Integrated Community Support Team (ICST) which provides support to vulnerable patients, including those that are classed as ‘frequent flyers’ to health care services. These patients have been found to require significant non-medical support and the ICST aims to direct patients to appropriate support services, including those in the voluntary sector. Ashfield Medical Centre provides space within its premises for the ICST for its PCN, which comprises two specialist nurses and social work assistant. The team visit each of the PCN practices weekly. In addition to the ICST, the PCN has also recruited a pharmacist and community support worker, who provide support to Ashfield Medical Centre for six hours each week. The practice also provides its patients with weekly onsite access to a MIND counsellor and mental health nurse. A dermatologist also provides a weekly clinic from the practice site.
The practice operates from a two-storey purpose-built property. Patient consultations and treatments take place on the ground level. There is a large car park outside the surgery, with disabled parking available. There is a pharmacy and a dental practice situated within the building but not attached to the practice.
Ashfield Medical Centre is open between 8am and 6.30pm Monday to Friday. The out of hours service can be accessed via the NHS 111 service. Information about this is available in the practice and on the practice website and telephone line.
The practice provides family planning, surgical procedures, maternity and midwifery services, treatment of disease, disorder or injury and diagnostic and screening procedures as their regulated activities.
Updated
21 November 2019
We carried out an announced comprehensive inspection at Ashfield Medical Centre also known as Dr Cassidy & Partners, on 22 January 2019. The overall rating for the practice was good with the practice rated as requires improvement for being safe.
From the inspection on 22 January 2019, the practice was told they must:
- Ensure care and treatment is provided in a safe way to patients.
In addition, the practice was told they should:
- Continue with efforts to identify and support carers within the practice population.
- Continue with efforts to improve patient satisfaction with particular regard to the areas highlighted in the results of the national GP patient survey as being in need of improvement.
- Monitor staff training to ensure timely completion of mandatory training.
- Complete proposed testing for staff to provide assurance on staff immunity status.
- Continue with efforts to reduce prescribing of antibacterial and hypnotic medicines where appropriate.
The full comprehensive report on the inspection carried out in January 2019 can be found by selecting the ‘all reports’ link for Ashfield Medical Centre on our website at .
This inspection was an announced focused inspection at Ashfield Medical Centre undertaken on 5 November 2019 as part of our inspection programme to follow up on concerns identified at our previous inspection.
We based our judgement of the quality of care at this service on a combination of:
- what we found when we inspected
- information from our ongoing monitoring of data about services and
- information from the provider, patients, the public and other organisations.
We have rated this practice as good overall and good for all population groups.
We found that:
- When incidents happened, the practice learned from them and improved their processes. In particular, improvements had been made to the management of safety alerts following concerns identified during our previous inspection.
- The practice was working to support and identify carers within the population. There were 120 registered carers at the time of our inspection. The practice was using the support of the Integrated Community Support Team (ICST) to identify and support carers. The ICST provided the practice with access to a social work assistant who was able to offer additional support and information to carers and their dependents.
- Systems for monitoring staff training had been developed. However, there was evidence of some gaps in record keeping. Immediately following our inspection, the practice submitted evidence to demonstrate these gaps were being filled.
- The practice was making continued efforts to improve patient satisfaction as highlighted in the national GP patient survey. There had been some improvement in the practice’s performance in the most recent patient survey. For example, at the time of our previous inspection 28% of patients were satisfied with access to the practice via the telephone. This had improved to 45% in the most recent survey data (01/01/2019 to 31/03/2019). Similarly, satisfaction with the overall patient experience had improved from 65.6% to 74%.
- All staff had been subject to appropriate testing of their immunity status in line with Public Health England Guidance. Those requiring additional vaccinations had received them.
- The practice was able to demonstrate reduction in prescribing of antibacterial and hypnotic medicines where appropriate and was continuing with efforts to improve further.
- The practice team displayed a willingness to learn and improve.
The areas where the provider should make improvements are:
- Ensure all staff training records are appropriately maintained, particularly those relating to mandatory training as specified by the practice.
- Continue with efforts to reduce prescribing of antibacterial and hypnotic medicines where appropriate.
- Continue with efforts to improve patient satisfaction with particular regard to the areas highlighted in the results of the national GP patient survey as being in need of improvement.
Details of our findings and the evidence supporting our ratings are set out in the evidence tables.
Dr Rosie Benneyworth BM BS BMedSci MRCGP
Chief Inspector of Primary Medical Services and Integrated Care