Ash Trees Surgery

Updated 22 June 2018

Ash Trees Surgery is located in Carnforth and is part of the Morecambe Bay Clinical Commissioning Group. The total patient population is approximately 15,000. There are branch surgeries in Bolton-le-Sands, Halton and Silverdale. We visited the main surgery and the Bolton-le-Sands and Halton branch surgeries during this inspection.

The main surgery building in Carnforth has level access with the reception and some patient rooms on the ground floor. There are reserved rooms on the ground floor for patients who cannot use stairs to access the first floor. There is also a pharmacy on site.

The staff team currently comprises 12 partners and four associate GPs. This includes both male and female doctors. Working alongside the GPs are a practice manager and assistant practice manager, an advanced nurse practitioner, six nurses, five primary health care support workers, 16 administration/reception staff, and a team of patient advisors and clinical auditors.

The practice population includes lower-than-average numbers of people under the age of 18, and a significantly higher-than-average number of people over the age of 65, in comparison with the national averages.

Surgery opening times at Ash Trees are between 8am and 7.30pm on Monday, 8am and 6.30pm on Tuesday and Friday, and 7.30am to 6.30pm on Wednesday and Thursday. Surgery hours at the branches are more restricted. When the surgery was closed the care and treatment needs of the patients were met by an out-of hours-provider, Bay Urgent Care.

Updated 22 June 2018

This practice is rated as Good overall. (Previous inspection November 2014 – Good)

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced inspection at Ash Trees Surgery on 26 April 2018 as part of our inspection programme.

At this inspection we found:

• The practice had clear systems to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes.
• The practice routinely reviewed the effectiveness and appropriateness of the care it provided. They ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated patients with compassion, kindness, dignity and respect.
• There was a proactive approach to understanding the needs of different groups of people and to deliver care in a way that met these needs and promoted equality. This included people who were in vulnerable circumstances or who had complex needs.
• Services were tailored to meet the needs of individual people and were delivered in a way to ensure flexibility, choice and continuity of care.
• Patients found the appointment system easy to use and reported that they were able to access care when they needed it.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw some areas of outstanding practice:

• A “Listening Service” was established by the practice. This was a free, confidential service facilitated by a volunteer chaplain listener on a weekly basis. Patients we spoke to on the day of inspection spoke highly of the service. In 2017, the service was used by 80 patients, some of whom attended for multiple sessions.
• A counsellor who was specially trained to support patients who were military veterans held a regular clinic at the practice. At the time of inspection the practice held a register of 20 patients who had served in the military.
• The practice had approached the local Citizens Advice Bureau (CAB) to set up a clinic at the practice. Patients could get advice from (CAB) staff about social issues, such as funding for carers. We spoke to patients who used the service, all of whom found it beneficial and told us it had allowed them to access information or funding they would have struggled to otherwise obtain.

The areas where the provider should make improvements are:

• Take steps to ensure the fire alarms at the branch practices are being checked regularly.
• Take measures to ensure the safety of the boiler at the main surgery.
• Investigate the reasons for lower than average results in some areas of the last National GP Patient Survey.
• Document verbal complaints made to the practice so they can be used to look for areas of improvement.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Updated 22 June 2018

Updated 22 June 2018

Updated 22 June 2018

Updated 22 June 2018

Updated 22 June 2018

Updated 22 June 2018