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Inspection Summary


Overall summary & rating

Good

Updated 10 August 2016

Bolton One is a multi-purpose health and leisure centre located in the town centre of Bolton, which is part of Bolton NHS Foundation Trust.

A range of outpatient and diagnostic imaging services are provided from Bolton One including general outpatients, children’s outpatients, rheumatology, biomechanics, physiotherapy, occupational therapy, podiatry, pre-operative assessment, breast screening, plain film x-ray and obstetric ultrasound. There is also a hydrotherapy pool.

We visited Bolton One on Wednesday 23rd March 2016 as part of the comprehensive inspection of Bolton NHS Foundation Trust.

Overall we rated Bolton One as ‘Good’ across the areas of safe, caring, responsive and well-led. We are currently not confident that we are collecting sufficient evidence to rate effectiveness for Outpatients & Diagnostic Imaging and as a result, we haven’t rated the effective domain for this location.

There were areas at Bolton One where the trust needs to make improvements.

Importantly, the trust must:

  • Ensure that paper records are stored securely.

  • Ensure that appropriately skilled staff are in place to provide a biological therapy treatment service.

In addition the trust should:

  • The trust should ensure that letters are provided to GPs in a timely way.

  • The trust should ensure that patients are kept informed about any delays in outpatient and diagnostic imaging services and should monitor how long patients wait to be seen.

  • The trust should ensure that the recovery plan for breast screening is completed within agreed timeframes.

  • The trust should consider participating in the Imaging Services Accreditation Scheme (ISAS) and the Improving Quality in Physiological Services (IQIPS) accreditation scheme.

Professor Sir Mike Richards

Chief Inspector of Hospitals

Inspection areas

Safe

Good

Updated 10 August 2016

Effective

Not sufficient evidence to rate

Updated 10 August 2016

Caring

Good

Updated 10 August 2016

Responsive

Good

Updated 10 August 2016

Well-led

Good

Updated 10 August 2016

Checks on specific services

Outpatients and diagnostic imaging

Good

Updated 10 August 2016

  • Outpatients and diagnostic imaging services were rated as good overall. Staff were encouraged to report incidents and lessons were learnt and shared. Infection control practices were good and audits were completed. Nursing, medical and allied health professional staffing was good with few vacancies. Procedures in relation to safeguarding adults and children were in place and understood and training rates were high. Improvements were needed in the way records were stored securely and records were not always available at the time of the patient appointment.
  • Services followed national and local guidelines based on evidence based practice. Local audits were completed to monitor performance against local guidelines and patient outcomes. Appraisal rates were high and staff were supported to develop extended knowledge and skills.
  • Care was good delivered to patients by caring, kind and compassionate staff. Patients were treated with dignity and respect. High numbers of patients would recommend outpatient and diagnostic imaging services to their friends and family.
  • The service was responsive to people’s needs. Services had been planned to meet the needs of local people. Patients were given a choice about where they went for their appointment in some specialities and services had been developed to allow direct referral from GPs. Diagnostic waiting times had been consistently better than the England average between January 2014 and November 2015. Overall, the 95% 18-week target for non-admitted patients was met each month between April 2015 and December 2015. However the breast screening service was not meeting targets in relation to the recall of women for mammography. National targets had been extended locally to allow a recovery plan. Patients individual needs were understood and considered when delivering care and treatment. Adjustments were made to remove barriers to people accessing services.
  • Outpatients and diagnostic imaging services were well-led locally because governance systems were in place to support the delivery of high quality care. Risks were understood and managed to reduce any impact upon the quality of service deliver. Risk registers were reviewed and updated regularly although we saw there were not adequate plans in place to ensure that the rheumatology team had appropriately trained permanent members of staff to deliver the biologic therapy service.