Dr Jinmi & Partners Also known as Houghton Regis Medical Centre

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This means we looked for evidence people had the best possible outcomes because their needs were assessed, care and treatment was provided in line with up-to-date best practice, and people were supported to live healthier lives.

At our last inspection we rated this key question Inadequate. At this inspection, the rating has changed to Requires Improvement.

This is because the service did not always make sure people’s care and treatment was effective and in line with up-to-date evidence-based best practice.

The practice had not met national targets for the numbers of patients being screened for the risk of cervical cancer nor for the numbers of children having immunisations against various infectious diseases. The practice did not always complete recommended health checks with patients.

However, the practice supported patients to live healthier lives and supported carers.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Data showed 29% of patients registered with the practice had 1 or more long-term conditions, such as asthma, chronic kidney disease (CKD), diabetes or hypothyroidism.

The practice identified and took action when test results indicated a patient may have an undiagnosed long-term condition. However, the practice did not always follow up when patients failed to attend an appointment.

The practice did not always work in line with current evidence-based best practice. For example, our clinical searches showed the practice did not always carry out a thorough assessment of the patient before prescribing them medicines to treat a flare-up of asthma to assess the severity of their symptoms or condition and make sure the treatment was appropriate. Our searches showed these medicines had not always been prescribed in line with current national guidance.

The practice did not always follow-up patients in line with national guidance after prescribing them medicines to treat a flare-up of asthma, to help prevent their asthma worsening and the risk of having a life-threatening asthma attack.

Patients were not always receiving treatment in line with national guidance. For example, the practice did not always make changes to patients’ ongoing medicines, in line with current national guidance, to ensure their asthma was managed as well as possible.

Of the 5 patients whose records we reviewed, there was no evidence 2 of the patients had been issued with a ‘Steroid Emergency Card’ when this would have been appropriate. The NHS issued a national patient safety alert in 2020 to make sure these cards were issued to patients at risk of developing a potentially fatal condition due to taking steroids for a medical condition, such as asthma. These cards alert healthcare professionals to potential risks to help them make sure patients are treated safely.

We also saw that for 1 patient, the practice had prescribed a medicine that should not be taken by people who have asthma because it can make the patient’s asthma worse and stop other asthma medicines from working.

Our searches of the practice’s clinical records system also identified 10 patients, 1% of the patients registered with the practice who had asthma, had been prescribed a high number of reliever inhalers over the last year. This could suggest the person’s asthma could be better controlled. We looked at the records for 5 of these 10 patients. Although the practice had completed asthma reviews with all 5 of the patients within the last year, there was no evidence the person completing the reviews had always identified the high use of reliever inhalers nor reviewed how the patient was using them. There was no evidence the person completing the review had discussed the patient’s medicines, or changes to their medicines with the patient, that could help improve the control of their asthma and ensure reviews were in line with national recommendations and guidance. Some of the patients were not prescribed medicines that were in line with up-to-date national guidance.

We also found some of these asthma reviews completed by the practice were not thorough or complete, meaning opportunities to make sure the patient’s asthma was managed as well as possible could have been missed.

We also noted 4 of these 5 patients had not had a review of all of their medicines for some time, which could include a review of the medicines the patient takes for asthma. The last medicine reviews recorded for 2 of the patients were in 2018. These reviews also did not include all of the medicines prescribed for the person, including medicines to help mental health.

Our searches of the practice’s clinical records system identified one patient with hypothyroidism was overdue monitoring and had not had a medication review coded on the clinical system since 2010.

The practice had monthly meetings with other services, including palliative care and community nurses, to discuss and coordinate care for patients nearing the end of life or who had more complex needs.

The practice took steps to make sure patients who had long-term conditions were monitored and reviewed in line with national guidance, to make sure their health and medicines needs were being met. This included patients whose test results suggested their diabetes could be better controlled and were at a higher risk of developing complications because of their diabetes, patients who were prescribed medicines to help make sure their hypothyroidism was managed as well as possible in most cases, and patients who had more advanced chronic kidney disease.

The practice supported national priorities and initiatives, for example the practice’s website had information for those wishing to stop smoking.

The website also had information to help keep people safe and to help them to manage common conditions, such as hay fever, or long-term conditions such as diabetes.

Information was available on the practice’s website about local and national services offering support, for example about autism; mental health; drug abuse; bereavement; and children’s health, pregnancy and maternity care.

Support from a Wellbeing Team was available for patients registered with the practice. This team supported people to access national and local services and activities to help with issues which are affecting their health and wellbeing, for example living with low mood or a long-term health condition, feeling stressed, or struggling with personal situations such as worries about money or housing problems.

Information was available in the waiting areas in the practice, for example about diabetes, asthma, stopping smoking, signs of cancers, domestic abuse, antibiotics, child health support and about a Young Person’s Wellbeing Navigator Service.

Posters informing adults about vaccinations available for them were displayed throughout the practice. The practice had also created an information folder for those making decisions about childhood immunisations. However, the practice did not promote the resource and had not kept the information in the folder up-to-date.

The practice identified people who may need extra support, for example unpaid or family carers. An unpaid or family carer is anyone who looks after a family member, partner or friend who needs help because of their illness, frailty, disability, mental health needs or drug or alcohol problem and cannot cope without their support. The care they give is unpaid.

Information for carers, and a form to register as a carer, was available on the practice’s website. However, there was no information about support for carers displayed in the practice’s waiting areas.

The practice had a ‘Carers Champion’ who helped support carers. For example, the Carers Champion provided information and could offer carers timely access to appointments with practice staff or make referrals to social prescribers. Carers were offered vaccinations, such as for flu, COVID-19 and pneumonia.

The latest information from the UK Health Security Agency (UKHSA) showed the practice was performing below the national targets for the number of children immunised against various infectious diseases. The national target is 95%. Data from the UKHSA showed:

• 88% of children aged 1 had completed a course of immunisation for Diphtheria, Tetanus, Polio, Pertussis, Haemophilus influenza type b (Hib) and Hepatitis B (Hep B).
• 89% of children aged 2 had received a booster immunisation for Pneumococcal infection (PCV booster).
• 90% of children aged 2 had received a booster immunisation for Haemophilus influenza type b (Hib) and Meningitis C (MenC).
• 89% of children aged 2 had had their first dose of immunisation for measles, mumps and rubella (MMR).
• 84% of children aged 5 had had 2 doses of immunisation for MMR.

Patients aged between 40 and 74 are eligible for an NHS health check. The practice told us they had completed a health check with 13% of patients registered with the practice who could have one.

Patients aged 75 and over are also eligible for an NHS health check. The practice did not record how many patients had received one.

The practice offered patients with a learning disability a yearly health check. At the time of this inspection, the provider told us 39 (61%) of the 64 patients registered with the practice who had been recorded as having a learning disability had had their yearly review.

Cervical screening (a smear test) is one of the best ways to help protect against and prevent cervical cancer. The latest information from NHS England showed that on 30 June 2024, 68% of patients registered with the practice who were aged 25 to 49 and eligible for this screening had been screened adequately within the recommended time period of 3 years 6 months. 75% of patients registered with the practice who were aged 50 to 64 and eligible for this screening had been screened adequately within the recommended time period of 5 years 6 months. The national target is 80%. The coverage of patients being screened had been consistently below this target since 2016.

Although the practice sent several message reminders to patients who had not responded to invitations to book an appointment to have a smear test when it was due, and booked appointments for patients to have a smear test opportunistically, information the practice provided for this inspection showed uptake was below the local and national averages, particularly for the younger age group. This data showed 73% of eligible patients aged between 25 and 49 and 81% of eligible patients aged between 50 and 64 had been screened.

Patients were advised chaperones were available. A chaperone is an impartial observer present during an examination or consultation when a patient may feel vulnerable, for example during an intimate examination. A chaperone acts to protect both patients and staff.

The provider had reviewed their Chaperone Policy in April 2025.

Staff who acted as a chaperone had completed training.

The provider had carried out ‘competency checks’ for 7 of the non-clinical members of staff who acted as chaperones.

Staff who gave us examples of when they had acted as a chaperone understood their responsibilities and described following an appropriate procedure that was in line with national standards.