Archived: Jacksdale Medical Centre

Updated 25 June 2015

Jacksdale Medical Centre is located in the village of Jacksdale, close to the Nottinghamshire / Derbyshire border. The practice provides services to people who live in Jacksdale and the surrounding villages.

The practice is a single handed GP practice, with support from two regular locum GPs. There is also a locum practice nurse, three health care assistant, practice manager and reception / administration staff. There are 3972 patients registered with the practice. The practice is open from 8am until 6pm Monday to Friday. The practice offers extended hours with the practice nurses on Mondays and Wednesdays. Additional appointments are available on these days for 7am until 8am. The practice treats patients of all ages and provides a range of medical services.

The practice holds a Personal Medical Services (PMS) contract with NHS England. This is a contract for the practice to deliver enhanced primary care services to the local community over and above the General Medical Services (GMS) contract.

Jacksdale Medical Centre has opted out of providing an out-of-hours service to its patients but has alternative arrangements for patients to be seen when the practice is closed. The out of hours service is provided by PC24 via NHS 111.

Updated 25 June 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Jacksdale Medical Centre on 6 March 2015. Overall the practice is rated as requires improvement.

Specifically, we found the practice to require improvement for providing safe and well led services. It was rated good for providing effective, caring and responsive services. The concerns we identified in the safe and well-led domains relate to everyone who uses the practice including the population groups. Therefore all the population groups we inspected were rated as requires improvement.

Our key findings were as follows:

• Staff understood and fulfilled their responsibilities to raise concerns, and to report incidents and near misses. However, information about safety was not always recorded, monitored, appropriately reviewed and addressed.
• Risks to patients were assessed and well managed, with the exception of those relating to recruitment checks.
• Although some audits had been carried out, we saw no evidence that audits were driving improvement in performance to improve patient outcomes.
• 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.
• Urgent appointments were usually available on the day they were requested. However patients said that they sometimes had to wait a long time for non-urgent appointments.
• The practice had a number of policies and procedures to govern activity. The practice did not hold regular governance meetings.

However, there were also areas of practice where the provider needs to make improvements.

Importantly, the provider must:

• Ensure the methods used for recording, reporting, investigating, review and dissemination of learning from significant events, near misses and complaints are robust.
• Ensure that all necessary employment checks are obtained and kept of file.

In addition the provider should:

• Strengthen infection prevention and control processes.
• Ensure audits complete their full cycle in order to demonstrate improvements made to practice.
• Introduce a system for checking that equipment is in date.
• Record all complaints and introduce a system to review complaints for trends or themes.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 25 June 2015

The practice was rated as good for effective, caring and responsive overall and this includes for this population group. The practice was rated as requires improvement in the domains of safe and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

We found that the nursing staff had the knowledge, skills and competencies to respond to the needs of patients with a long term condition such as heart disease and asthma. Longer appointments and home visits were available when needed. The practice maintained registers of patients with long term conditions. All these patients were offered structured annual review to check that their health and medication needs were being met. Recall systems were in place to ensure patients attended.

Updated 25 June 2015

The practice was rated as good for effective, caring and responsive overall and this includes for this population group. The practice was rated as requires improvement in the domains of safe and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

We saw that the practice provided services to meet the needs of this population group. Urgent appointments were available for children who were unwell. Staff were generally knowledgeable about how to safeguard children from the risk of abuse. Systems were in place for identifying children who were at risk, and there was a good working relationship with the health visitor attached to the practice.

Updated 25 June 2015

The practice was rated as good for effective, caring and responsive overall and this includes for this population group. The practice was rated as requires improvement in the domains of safe and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

Every patient over the age of 75 years had a named GP. Influenza and shingles vaccinations were offered to older patients in accordance with national guidance. Home visits to patients in their own homes or care homes were carried out when requested. Monthly multi-disciplinary care meetings were held to ensure integrated care for older people with complex health care needs.

Updated 25 June 2015

The practice was rated as good for effective, caring and responsive overall and this includes for this population group. The practice was rated as requires improvement in the domains of safe and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

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 pro-active in offering on line services as well as a full range of health promotion and screening services which reflected the needs of this age group. The practice offered all patients aged 40 to 74 years old a health check. Family planning services were provided by the practice for women of working age. Diagnostic tests, that reflected the needs of this age group, were carried out at the practice.

Updated 25 June 2015

The practice was rated as good for effective, caring and responsive overall and this includes for this population group. The practice was rated as requires improvement in the domains of safe and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

The practice was proactively assessing patients with risk factors associated with dementia. The practice regularly worked with multi-disciplinary teams in the case management of patients experiencing poor mental health. The practice had direct links to the mental health crisis team, and ensured that patients and families had contact details for access when the practice was closed.

Updated 25 June 2015

The practice was rated as good for effective, caring and responsive overall and this includes for this population group. The practice was rated as requires improvement in the domains of safe and well-led. The concerns which led to these ratings apply to everyone using the practice, including this population group.

The practice held a register of patients with a learning disability. It had carried out annual health checks for patients with a learning disability.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable patients. Staff knew how to recognise signs of abuse in vulnerable adults and children. Most 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.