Archived: Jolly Medical Centre

Updated 9 July 2015

The Jolly Medical Practice is located in a residential area of Crumpsall North Manchester. The service is near to the local NHS trust and has a close working relationship with the Trust. It is part of the NHS North Manchester Clinical Commissioning Group (CCG.) Services are provided under a general medical service (GMS) contract with NHS England. There are 3143 registered patients.

Dr Jolly the registered manager had received an MBE from the Queen for services to Medicine and Health Care in the local Community.

The practice population includes a lower number (8.8%) of people over the age of 65, and a higher number (51.8%) of people under the age of 18, in comparison with the national average of 30.6% and 36.2% respectively. The practice also has a lower percentage of patients who have caring responsibilities (12%) than both the national England average (18.4%) and the CCG average (17.1%).

Information published by Public Health England, rates the level of deprivation within the practice population group as two on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

The practice telephone lines opens from 9am to 6 pm Monday to Fridays except Wednesday when they close at 1pm. Appointments are offered between 9am and 6pm every day except Wednesday when they close at 1pm. They also held seasonal Flu vaccination clinics at certain times of the year. Patients requiring a GP outside of normal working hours are advised to contact an external out of hour’s service provider GoToDoc. The practice also had access to one appointment per day after 6pm including any time at weekends and bank holidays at a local Primary Care Centre, this appointment could be used for an urgent or routine appointment. This appointment was allocated to a patient following consultation with the GP. 

The practice has two GP partners, both male and a regular female locum for one session per week. The locum GP was available as required for additional sessions and they covered all GP holidays and sickness. One practice nurse, a practice manager, reception and administration staff supported the GPs within the practice.

On-line services include appointment booking and ordering repeat prescriptions.

Updated 9 July 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Jolly Medical Practice on 9 June 2015. Overall the practice is rated as good.

Specifically, we found the practice to be good for providing, safe, effective, caring, responsive and well led services to patients.

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

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The practice was actively involved in local and national initiatives to enhance the care offered to patients.
• Risks to patients were assessed and well managed.
• Patients’ needs were assessed and care was planned and delivered after considering 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 was provided to help patients understand the care available to them.
• The practice implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients
• The practice had a clear vision that had improvement of service quality and safety as its top priority. High standards were promoted and there was good evidence of team working.

We saw several areas of outstanding practice including:

• A comprehensive locum pack which contained processes and paperwork used by the practice. This was available complete with copies of forms to be used for referral to other services and key contact numbers for practice member’s and other services that may be required.
• An electronic pad for recording friends and family feedback was available to the patients in the waiting room.
• An electrocardiogram service was linked directly to a clinician for instantly reporting on ECG’s taken within the practice. An ECG records the electrical activity of the heart.
• The practice had achieved 100% of children vaccinated in the childhood immunisation programme despite the challenges presented by a culturally diverse population where English was not the first language for many patients.
• Awareness of staff to signpost patients to alternative and supportive services for those patients who may experience long delays in their referral to other NHS services fin particular Mental Health support for teenagers.

In addition the provider should;

• Ensure team meetings are scheduled throughout the year to ensure staff are fully aware of changes at the practice.
• Ensure the practice nurse is fully involved in clinical and professional meetings within the Clinical Commissioning Group and practice to ensure she is up to date with changes in professional practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 9 July 2015

The practice is rated as good for the care of people with long term conditions. The practice had effective assessment, care planning and recall arrangements for patients with long term conditions. The practice nurse and GPs had lead roles for the management of patients with long term conditions and the practice had identified patients at risk of unplanned hospital admissions. They had identified the 2% of patients registered with the practice who were at the highest risk and had developed written care plans for those patients. Those patients and others with long term conditions had annual reviews of their health and medicines. Longer appointments or home visits were arranged for these according to individual need.

Updated 9 July 2015

The practice is rated as outstanding for the care of families, children and young people. Staff demonstrated a good understanding and were proactive in safeguarding and protecting children from the risk of harm or abuse. The practice had a clear means of identifying in records those children (together with their parents and siblings) who were subject to a child protection plan and who were in looked after conditions. The practice had appropriate child protection policies in place to support staff and staff were trained to a level relevant to their role. Immunisation clinics for babies and young children were available on a weekly basis. The midwives carried out a clinic in the practice on Tuesday for pregnant ladies these clinics were supported a GP for any addition needs the ladies may encounter. Appointments both routine and urgent were available outside school hours and the premises were suitable for children and babies. Children needing urgent appointments were seen as soon as possible at the surgery. Children and young people were treated in an age appropriate way and recognised as individuals. The population of under 18 year olds (0-18 years) accounted for 51.8% of the practice patient population which is higher than both the Clinical Commissioning Group (CCG) and the national averages for this age group (36.2% and 31.9%) . 24% of these were aged between 14-18 years of age compared with CCG averages at 20% and nationally 14.7%. The practice had achieved 100% of children vaccinated in the childhood immunisation programme despite the challenges presented by a culturally diverse population where English was not the first language for many patients.

Updated 9 July 2015

The practice is rated as good for the care of older people. From the practice list size of 3143 patients 188 patients were aged 65 and over, this equated to 6% of the practice population. The practice offered a named GP for those patients who were 75 years and older in line with the GP contracting arrangement. The practice had a system for ensuring elderly patients requiring urgent care were seen on the same day. Systems were in place to support those giving care to older people. The practice had a register of patients who needed care and support at the end of their lives and took part in meetings with other professionals involved in their care.

Updated 9 July 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 reflected the needs for this age group.

Updated 9 July 2015

This practice is rated as good for the care of people experiencing poor mental health (including people with dementia). The practice held a register of people experiencing poor mental health and invited them to attend for an annual health check. Longer appointments were arranged for this and patients were seen by the GP they preferred. The annual reviews took into account patients’ employment, home circumstances and support networks in addition to their physical health. At the time of the inspection the practice had 23 patients on its Mental Health register.

The practice had a counsellor who attended weekly, patients were referred and seen within the practice so that they would be comfortable discussing any issues within a familiar environment. The practice had identified patients who required dementia screening and added alerts to the patients’ medical records so clinicians were aware an assessment is required. The practice currently had 7 patients on the dementia register; currently 86% of these patients have had an annual review.

Due to pressures within the local Child and Adolescent Mental Health Service team the practice were experiencing delays in appointment times for referred young patients to this service. The practice secretary had researched charity organisations that could support both the young person and their family whilst they waited for their appointments. These details were made available to patients and relatives in a bid to ensure they were supported effectively until their appointment came through.

Updated 9 July 2015

This practice is rated as good for the care of people living in vulnerable circumstances. The practice had a learning disability (LD) register and all patients with learning disabilities were invited to attend for an annual health check. Longer appointments were available for this and the practice used information in suitable formats to help them explain information to patients. Staff told us that the practice did not have any homeless people or traveller families currently registered at the practice. Staff at the practice worked with other professionals to help ensure people living in difficult circumstances had opportunities to receive the care, support and treatment they needed. The staff team were aware of their responsibilities regarding information sharing and dealing with safeguarding concerns. Patients attending the practice who were assessed by the GP as requiring an electrocardiogram (ECG records the electrical activity of the heart) was able to have this test and wait for the report in one visit to the practice. The practice offered a service which was linked directly to an external ECG clinician for instant reporting on those taken and results were shared with patients in real time to stop them worrying unnecessarily about the results.