Archived: Great Lever Practice Also known as SSP Health Ltd

Updated 19 November 2015

Great Lever Practice is a GP surgery situated in the Great Lever area of Bolton. Great Lever Practice is one of two GP practices that are situated within Bolton Medical Centre (the provider for both practices is SSP Health Limited). At the time of this inspection we were informed 2,167 patients were registered with Great Lever Practice.

The practice population experiences much higher levels of income deprivation than the practice average across England. There is a lower proportion of patients above 65 years of age (11.7%) than the practice average across England (16.9%). The practice has a higher proportion of patients under 18 years of age (27.6%) than the practice average across England (20.7%). 63.2 per cent of the practice’s patients have a longstanding medical condition compared to the practice average across England of 54%.

At the time of our inspection two salaried GPs were providing primary medical services to patients registered at the practice supported by locum GPs when required. The GPs were supported in providing clinical services by two practice nurses, one assistant practitioner and one health care assistant. Clinical staff were supported by the practice manager and the other members of the practice reception/administration team. Also the provider’s managerial and clinical support team provided leadership and support to the practice staff.

The opening times of the practice were 8am to 6.30pm Monday to Friday. GP appointment times were 8.30am to 1pm and 3pm to 6pm Monday to Friday. The practice has opted out of providing out-of-hours services to their patients. In case of a medical emergency outside normal surgery hours advice was provided by Bury and Rochdale Doctors (BARDOC). The practice website and patient information leaflet available at the practice details how to access medical advice when the practice is closed. Patients are also provided with these details via a recorded message when they telephone the practice outside the usual opening times.

The practice contracts with NHS England to provide Alternative Provider of Medical Services (APMS) to the patients registered with the practice.

Updated 19 November 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Great Lever Practice on 9 October 2015. Overall the practice is rated as good.

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

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. Information about safety was recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles and any further training needs had been identified and planned.

• 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.
• Patients said they found it easy to make an appointment and that 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.

We saw one area of outstanding practice:

Great Lever Practice has access to an on-site gymnasium that offers free membership to any registered patients. We saw evidence that that the use of this facility has improved some registered patients health.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 November 2015

The practice is rated as good for the care of people with long-term conditions. Clinical staff had key roles in chronic disease management and patients at risk of hospital admission were identified as a priority. Longer appointments and home visits were available when needed. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 19 November 2015

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 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. Appointments were available outside of school hours and the premises were suitable for children and babies. We saw good examples of joint working with midwives and health visitors.

Updated 19 November 2015

The practice is rated as good for the care of older people. Nationally reported data showed that outcomes for patients were good for conditions commonly found in older people. The practice offered proactive, personalised care to meet the needs of the older people in its population and had a range of enhanced services, for example, in dementia and avoiding unplanned admissions. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with enhanced needs. All patients over 75 years of age had a named accountable GP and are offered a health check. Great Lever Practice offers free gym facilities to patients of all ages to actively promote and support healthier lifestyles.

Updated 19 November 2015

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. The practice offers a free audiology service at the practice. The practice also facilitates fortnightly ultrasound clinics at the practice so patients do not have to travel to hospital.

Updated 19 November 2015

The practice had carried out annual health checks for people experiencing poor mental health. The practice regularly worked with multi-disciplinary teams in the case management of people experiencing poor mental health including those with dementia. The practice had sign-posted patients experiencing poor mental health to various support groups and third sector organisations such as MIND. There was a system in place to follow up on patients who did not attend practice appointments or had attended accident and emergency where there may have been mental health needs. The practice currently has 25 patients on the mental health register, and 96% had a mental health care plan that was agreed and reviewed. There were plans in place for the remaining patients to be recalled for review before the end of March 2016.

Updated 19 November 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. It had carried out annual health checks for people with a learning disability. It offered longer appointments for people with a learning disability. The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It had told 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. The practice had a carer’s champion who identified patients with carer responsibilities and referred them to the local carers centre and relevant community services.