Bolton Community Practice CIC

Updated 1 December 2016

Bolton Community Practice CIC provides primary medical services in Bolton from Monday to Friday. The surgery is open Monday to Friday between 8am to 7.30pm and Saturday between 9am and 12pm.

Appointments with a GP at Bolton Community Practice CIC are available:

Navigation Park,(known locally as Astley Dale Surgery)

Monday to Friday 8.30am to 12pm and 2.30pm to 7.20pm

Saturday 9am to 7.20pm

Little Lever, Mytholm Road, Bolton, BL3 1JF

Monday, Tuesday, Thursday and Friday 8.30am to 5.30pm

Wednesday 8.30 to 1pm

Ladybridge, 10 Broadgate, BL3 4PZ

and The Market Surgery, 103 Chorley New Road, Horwich, BL6 5QF

Monday to Friday 8.30am to 5.30pm

Bolton Community Practice CIC is situated within the geographical area of Bolton Clinical Commissioning Group (CCG) and is responsible for providing care to 11602 patients.

The practice has an Alternative Primary Medical Services (APMS) contract. The APMS contract is the contract between general practices and NHS England for delivering primary care services to local communities.

The practice consists of seven GPs, four male and three female, one advanced nurse practitioner and four practice nurses, one assistant practitioner and two health care assistants and is supported by a practice manager and a support team. It is a teaching practice with regular trainee GPs and medical students.

When the practice is closed patients are directed to the out of hour’s service run by Bury and Rochdale Doctors on Call (BARDOC)

The practice is part of a group of practices who offer appointments to a GP and practice nurse seven days a week.

The practice had achieved Bronze standard in Investors in People.

Updated 1 December 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Bolton Community Practice CIC on 17 October 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients said there was continuity of care, with urgent appointments available the same day.
• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a clear leadership structure and staff felt supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.
• The practice had two members of staff who were fully trained dementia friends and had further training sessions booked for all other members of staff.
• The practice had introduced a dementia friendly coloured chair in the waiting area and dementia friendly coloured signs throughout the surgery.

We saw areas of outstanding practice:

• The practice cared for patients on Bolton’s Violent Patient (Safehaven) Scheme. These patients had a GP key worker and were risk assessed on arrival on to the scheme. The patients had a dedicated telephone line and were provided with a range of appointments at quieter times across the week with named GPs, a security guard was also present in the building to support the service. The practice worked closely with the patients, their carers and the prison, probation, drug and alcohol services and mental health services to meet the needs of these patients. Patients were able to register on the regular list when they were removed from the scheme. The practice held a quarterly meeting to review any risks, share appropriate information and review patients care planning.
• The practice worked closely with a local charity, Urban Outreach, and the local foodbank to offer support for their vulnerable adults struggling with difficult lives, including homelessness. One member of staff had been trained and was able to issue food bank vouchers.
• The practice held weekly coffee mornings for vulnerable patients that were lonely and socially isolated.

Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 1 December 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.
• 92% of patients on the diabetes register had a record of a foot examination and risk classification within the preceding 12 months which was comparable to the national average of 88%.
• Longer appointments and home visits were available when needed.
• Patients with multiple long term conditions were offered one review appointment so that they didn’t have to make repeat visits to the surgery.
• 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.
• Patients were encouraged to manage their own long term condition and were able to access their records and view their results on line.
• The Health Trainers at the practice organised community walks for patients who wanted to improve their fitness levels.
• The practice website provided links to resources for patients in this population group.

Updated 1 December 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. Immunisation rates were relatively high for all standard childhood immunisations.
• 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.
• 80% of women aged between 25 and 64 had their notes recorded that a cervical screening test had been performed in the preceding five years which was comparable to the national average of 82%.
• Appointments were available outside of school hours and the premises were suitable for children and babies.
• Children under the age of 12 were offered same day appointments when required. Parents were also able to access a minor illness clinic and a daily telephone advice service led by a nurse or a pharmacist.
• The practice responsive service for acute minor illness in children had reduced the number of A&E attendances for minor issues. This was evidenced by the CCG quality contract.
• We saw positive examples of joint working with midwives, health visitors and school nurses.
• New mums were offered post natal checks at the same time as their babies six to eight week check.
• A confidential chlamydia screening service was offered by the practice.

Updated 1 December 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.
• All patients over the age of 75 had a named GP and a structured annual review to check their health and medicine needs were being met. For those patients with the most complex needs, the named GP worked with the relevant health and care professionals to deliver a multidisciplinary package of care.
• The practice were working with Bolton Council to provide Health and Wellbeing sessions to local sheltered residents who were patients at the practice.
• The practice was responsive to the needs of older people, and offered home visits, longer appointments and urgent appointments for those with enhanced needs.
• The waiting rooms in the main surgery and each of the branch surgeries had seating suitable for patients with mobility problems.
• The practice embraced the Gold Standards Framework for end of life care. This included supporting patients’ choice to receive end of life care at home.
• Two of the practice staff were trained dementia friends with training booked for all other staff.
• The practice had dementia friendly coloured chairs and signs in each of its surgeries.
• The practice worked together with Bolton’s Staying Well and integrated teams to support the health and wellbeing of patients over the age of 75 in their own homes.

Updated 1 December 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.
• 22% of patients had registered for online services which included ordering prescriptions, booking appointments and access to full medical records.
• Telephone appointments were offered each day at each of the practice sites for patients that were unable to attend the surgery during normal working hours.
• GP appointments were offered until 7.30pm each evening and Saturday mornings at The Waters Meeting Road site for working patients.
• A nurse was available every Saturday to offer routine screening, phlebotomy and travel advice.

Updated 1 December 2016

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

• 87% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the national average of 83%.
• 94% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive, agreed care plan documented in their record in the preceding 12 months which was above the national average of 89%.
• The practice offered dementia screening to all its elderly patients.
• The practice regularly worked with multi-disciplinary teams in the case management of patients 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. Two of the practice staff had been trained and were dementia friends and the practice had further training sessions booked to ensure that all staff were trained dementia friends.
• Each of the practice sites had dementia friendly coloured chairs in the waiting areas and dementia friendly coloured signs throughout the surgeries.
• The practice actively identified military veterans and asylum seekers who may have unidentified mental health needs.

Updated 1 December 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 cared for patients on Bolton’s Violent Patient (Safehaven) Scheme. These patients had a GP key worker and were risk assessed on arrival on to the scheme. The patients had a dedicated telephone line and were provided with a range of appointments at quieter times across the week with the named GPs, a security guard was also present in the building to support the service. The practice worked closely with the patients, their carers and the prison, probation, drug and alcohol services and mental health services to meet their needs. Patients were able to register as regular patients when they were removed from the scheme.
• The practice worked closely with a local charity, Urban Outreach, and the local foodbank to offer support for their vulnerable adults struggling with difficult lives, including homelessness. One member of staff had been trained and was able to issue food bank vouchers.
• The practice offered longer appointments for patients with a learning disability.
• The practice regularly worked with other health care professionals in the case management of vulnerable patients.
• 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.
• There was a safeguarding board in the waiting area which gave patients information and support available to them.
• A room was made available, if required, for patients who were receiving support from IRIS which is an organisation who offered support to patients suffering from domestic violence.
• Patients whose first language is not English were given double appointments to ensure appropriate use of Language Line translator service.