Humberstone Medical Centre

Updated 7 September 2016

Humberstone Medical Centre was first established in 1952 and provides primary medical services to approximately 9,425 patients within Leicester City and is located within a spacious, purpose built health centre. The practice also provides services to patients residing in 13 nursing and residential homes in the surrounding area which included two learning disability homes.

The practice has seen a steady increase in its patient list size increasing year on year from 8,127 patients in 2009 to its current list size of 9,425 patients. It was anticipated that the list size would continue to increase due to the recent closure of two other local GP practices.

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.

At the time of our inspection the practice consisted of four GP partners, two salaried GPs, two GP Registrars, a practice manager, assistant practice manager, reception manager, nurse team manager/advanced nurse practitioner, two practice nurses, two health care assistants, two phlebotomists, and a reception and administration team.

All GPs have specialist clinical interests in areas such as palliative care, adolescent mental health, chronic heart disease and heart failure, diabetes, dermatology and minor surgery.

Humberstone Medical Centre is open from 8am to 6.30pm Monday to Friday. The practice provides extended opening hours on a Monday until 8pm and on a Tuesday until 8.30pm. The practice is part of a pilot scheme within Leicester City which offers patients an evening and weekend appointment with either a GP or advanced nurse practitioner at one of four healthcare hub centres. Appointments are available from 6.30pm until 10pm Monday to Friday and from 9am until 10pm on weekends and bank holidays. Appointments are available by walk in, telephone booking or direct referral from NHS 111.

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 25-59 years of age and also a higher than average elderly population and a higher than average level 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.

Updated 7 September 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Humberstone Medical Centre - IP Jones on 25 April 2016. Overall the practice is rated as good.

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

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.

• 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.

• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.

• 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 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.

• The practice had an active patient participation group (PPG) who met on a regular basis and arranged health promotion events within the practice for patients.

• The provider was aware of and complied with the requirements of the duty of candour.

The areas where the provider should make improvement are:

• Review process and methods for identification of carers and the system for recording this. To enable support and advice to be offered to those that require it.

• Address the issues highlighted in the national GP survey in order to improve patient satisfaction, including in respect of appointment access in relation to GP appointments.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 7 September 2016

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 provided weekly in-house diabetic clinics with provided by trained practice nurses.

• Performance for diabetes related indicators was 93.2% which was higher than the national average of 89.2%. (This included an exception reporting rate of 12.3% which was higher than the CCG average of 7.9% and the national average of 10.8%).

• 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 7 September 2016

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 78% and the national average of 82%.

• 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. Health visitors attended the practice twice weekly and also attended regular in-house meetings.

Updated 7 September 2016

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.

• Patients received personalised care plans from a named GP to support continuity of care.

• The premises were accessible to patients with mobility difficulties.

• Those at high risk of hospital admission and end of life care needs were identified and reviewed regularly, this included working with other health professionals to provide co-ordinated care.

Updated 7 September 2016

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 participated in an electronic prescribing service.

• The practice offered a text reminder service for booked appointments.

• The practice had recently introduced a ‘virtual surgery’ which enabled patients to access improved services on-line, this included the ability to ask a GP or nurse a question or check the progress of secondary care referrals made by the practice.

Updated 7 September 2016

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 99.5% which was higher than the national average of 92.8%. (This included an exception reporting rate of 23% which was higher than the CCG average of 8.4% and the national average of 8.1%).The practice provided weekly counselling clinics for those patients who experienced poor mental health to improve access to support for these patients.

• 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.

Updated 7 September 2016

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.