The Jubilee Medical Practice

Updated 27 April 2017

The Jubilee Medical Practice provides primary medical services to approximately 11,071 patients in Syston, East Leicestershire. The practice also provides services to patients residing in six residential care homes in the surrounding area, one of which cares for patients with learning disabilities.

The practice is registered with the Care Quality Commission to provide the regulated activities of; the treatment of disease, disorder and injury; diagnostic and screening procedures; family planning, maternity and midwifery services and surgical procedures.

The practice is a training practice and delivers training to GP registrars. A GP registrar is a fully qualified doctor who is training to become a GP.

The practice is a provider hub delivering training in conjunction with Health Education East Midlands (HEEM) working in partnership with multiple universities to deliver education and training to postgraduates and undergraduates such as medical students, student nurses and student pharmacists from King’s College London, University College London, University of Leicester, University of Nottingham and De-Montfort University.

At the time of our inspection the practice employed a team of male and female GPs which consisted of eight GP partners (three female and five male) two salaried GPs and two GP registrars. They are supported by a practice manager, one advanced nurse practitioner, three practice nurses, one lead health care assistant (HCA) and three HCAs, one finance and HR assistant, one reception manager, one senior receptionist and eight receptionists which includes one apprentice, one operations lead, one secretary/IT lead, one data co-ordinator and health and safety lead and three administration apprentices.

The Jubilee Medical Practice is open from 8am until 6.30pm Monday to Friday with the exception of a Thursday evening when the practice is open until 7pm. The practice also offers a combination of face to face and telephone consultation appointments from 7.30am until 8am Monday to Friday.

The practice has a General Medical Services (GMS) contract. The GMS contract is the contract between general practices and NHS England for delivering care services to local communities.

The practice has a higher population of patients between the ages of 45 and 65 years of age and the patient list has low levels of deprivation.

The practice has an active patient participation group (PPG) who meet on a regular basis. The practice offers on-line services for patients including ordering repeat prescriptions, booking routine appointments and viewing patient summary care records.

The practice lies within the NHS East Leicestershire and Rutland Clinical Commissioning Group (ELCCG). A CCG is an organisation that brings together local GPs and experienced health professionals to take on commissioning responsibilities for local health services.

When the practice is closed patients are able to use the NHS 111 out of hour’s service.

Updated 27 April 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Jubilee Medical Practice on 24 November 2016. 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 report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.

• The practice was a provider hub and delivered training in conjunction with Health Education East Midlands (HEEM) and worked in partnership with multiple universities to deliver education and training to postgraduates and undergraduates such as medical students, student nurses and student pharmacists from King’s College London, University College London, University of Leicester, University of Nottingham and De-Montfort University.

• The practice manager had developed an introduction to general practice course which was commissioned across Leicester, Leicestershire and Rutland (LLR) CCGs. This course was designed for non-clinical staff to give an overall introduction to working in general practice. A further course was developed specifically for HCA’s and practice nurses.

• The practice held a combined care clinic for patients who suffered with multiple long term conditions and chronic diseases. This clinic was a one stop shop for patients which were held by a team which included a GP, practice nurse and HCA to ensure patients health needs were discussed and met where possible during one appointment, reducing the amount of visits to the practice required.

• The practice had good facilities and was well equipped to treat patients and meet their needs.

• Risks to patients were assessed and well managed. The practice had an effective risk register in place and had carried out numerous risk assessments which were reviewed on a regular basis.

• 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.

• The practice actively reviewed complaints and how they are managed and responded to, and made improvements as a result.

• The practice had a clear vision which had quality and safety as its top priority. The strategy to deliver this vision had been produced with stakeholders and was regularly reviewed and discussed with staff.

• The practice had strong and visible clinical and managerial leadership and governance arrangements.

We saw one area of outstanding practice:

• A GP in the practice was a ‘dementia champion’ and had created a template for use in the early identification of dementia in patients which had been shared for wider use with other practices within NHS East Leicestershire and Rutland CCG (ELCCG). This template was developed in collaboration with the CCG and was shared for wider use within NHS West Leicestershire CCG (WLCCG) and NHS Leicester City CCG (LCCCG) following requests and positive feedback received.

However there were areas of practice where the provider should make improvements:

• Continue to monitor actions taken in relation to the issues highlighted in the national GP patient survey in order to improve patient satisfaction, including appointment access and c are planning and involvement in decisions about care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 27 April 2017

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.

• The practice held a combined care clinic for patients who suffered with multiple long term conditions and chronic diseases. This clinic was a one stop shop for these patients which were held by a team which included a GP, practice nurse and a HCA to ensure patients health needs were discussed and met where possible during one appointment, reducing the amount of visits to the practice required.

• Performance for diabetes related indicators was 97% which was higher than the CCG average of 92% and the national average of 90%. (Exception reporting rate was 8% which was lower than the CCG average of 11% and the national average of 12%).

• Longer appointments and home visits were available when needed.

• 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.

Updated 27 April 2017

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.

• The practice’s uptake for the cervical screening programme was 81%, which was comparable to the CCG average of 79% and the national average of 74%.

• Appointments were available outside of school hours and the premises were suitable for children and babies.

• We saw positive examples of joint working with midwives, health visitors and school nurses.

• The practice took part in a teenage and young people’s well-being scheme which was devised due to the increasing need for planned care for mental health/emotional problems within the local population. This scheme enabled patients up to the age of 19 to access a weekly chat zone to discuss sexual health and teenage pregnancy.

Updated 27 April 2017

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.

• The practice was responsive to the needs of older people, and offered home visits and urgent appointments for those with enhanced needs.

• An integrated care lead provided regular visits to patients in their own homes in response to their needs, and carried out reviews and referrals where necessary to ensure their health and social care needs were being met.

• The practice held a bi-annual care homes meeting in which the practice invited care home staff to the practice to discuss what goes well, what doesn’t go well, any challenges or improvements required in relation to the care and treatment of patients of the practice who reside in care homes.

Updated 27 April 2017

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 offered extended hours appointments on a Thursday evening until 7pm for working patients who could not attend during normal opening hours.
• The practice offered on-line services for patients which included ordering repeat prescriptions, booking routine appointments and viewing patient summary care records.

Updated 27 April 2017

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

• Performance for mental health related indicators was 100% which was higher than the CCG average of 97% and the national average of 92%. (Exception reporting rate was 39% which was higher than the CCG average of 30% and the national average of 11%).

• Performance for depression related indicators was 100% which was higher than the CCG average of 96% and the national average of 92%. (Exception reporting rate was 19% which was lower than the CCG average of 23% and the national average of 22%).

• 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.

• All clinicians had received training in the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). All practice staff had completed dementia awareness training.

Updated 27 April 2017

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 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.