Archived: Jiggins Lane Medical Centre

Updated 18 April 2016

Jiggins Lane Medical Centre is part of the NHS Birmingham Cross City Clinical Commissioning Group (CCG). CCGs are groups of general practices that work together to plan and design local health services in England. They do this by 'commissioning' or buying health and care services.

Jiggins Lane Medical Centre is registered with the Care Quality Commission to provide primary medical services. The practice has a general medical service (GMS) contract with NHS England. Under the GMS contract the practice is required to provide essential services to patients who are ill and includes chronic disease management and end of life care.

The practice is located in purpose built accommodation. Based on data available from Public Health England, deprivation in the area served is higher than the national average. The practice has a registered list size of approximately 7200 patients.

The practice is open between 8.30am and 6.30pm Monday to Friday, although closes between 12.30pm and 1.30pm daily with the exception of Thursday when it closes from 1pm for the afternoon. Appointments are available between 9am and 11.50pm daily, 3.30pm to 5.50pm Monday and Wednesday, 3.30pm and 7.30pm on a Tuesday (when it has extended opening) and between 3pm and 5.30pm on a Friday. When the practice is closed primary medical services are provided by an out-of-hours provider.

The practice currently has six GP partners (3 male and 3 female), three salaried GPs (1 male and 2 female) and a GP retainer (a flexible arrangement to support qualified GPs to maintain their skills who are otherwise unable to commit to permanent working hours). Other practice staff consist of a team of four practice nurses (including one nurse prescriber), a healthcare assistant and a phlebotomist. There is a team of administrative staff which includes a practice manager who supports the daily running of the practice.

The practice is a training practice for qualified doctors training to become a GP and also supports training for physician associates.

The practice has not previously been inspected by CQC.

Updated 18 April 2016

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Jiggins Lane Medical Centre on 26 February 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. Effective systems were in place for reporting and recording significant events so that staff could learn from them. The practice also shared learning from incidents both externally with other practices.
• Risks to patients were assessed and well managed.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had the skills, knowledge and experience to deliver effective care and treatment.
• The practice worked closely with other organisations and practices and participated in CCG led schemes to develop services provided. For example, improving the availability of diagnostic and patient monitoring services and in managing referrals to secondary care.
• 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.
• The practice performance was above CCG and national averages in many areas relating to patient outcomes and patient satisfaction in the services provided.
• Most patients said they found it easy to make an appointment, they were able to see a named GP if they were willing to wait and urgent appointments were available the same day.
• 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 was well organised and proactively sought feedback from staff and patients, which it acted on. The provider was aware of and complied with the requirements of the Duty of Candour.

The areas where the provider should make improvements are:

• The practice should review exception reporting where it is high to identify the reasons for this and implement any action as appropriate.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 18 April 2016

The practice is rated as good for the care of people with long-term conditions.

• Patients with long term conditions received regular reviews of their conditions to check their health and medicines needs were being met. Staff undertaking these reviews used and accessed best practice guidance available.
• A range of clinics for patients with specific long term conditions were held at the practice including asthma, chronic obstructive pulmonary disease, diabetes and coronary heart disease.
• Nursing staff had lead roles and had received training in chronic disease management.
• The practice provided a range of services in-house or in conjunction with other local practices to support the management of patients with long term conditions. For example 24 hour blood pressure monitoring, electrocardiographs and micro spirometry.
• Longer appointments and home visits were available for those who needed them.
• For those patients with the most complex needs, the practice worked with relevant health and care professionals to deliver a multidisciplinary package of care.
• Performance for diabetes related indicators was at 92% which was higher than both the CCG average and national average of 89%. The practice held quarterly diabetes meetings to discuss updates and patient care.

Updated 18 April 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 of failed to attend for immunisations.
• Immunisation rates were higher than CCG averages for standard childhood immunisations.
• The percentage of patients diagnosed with asthma, on the register, who had an asthma review in the last 12 months was 77% which was above the CCG average of 74% and national average of 75%.
• The practice offered baby friendly facilities. A breast feeding friendly service was advertised and baby changing facilities were available. There was a dedicated area for small children to play in the waiting area and information for young mums.
• Appointments were available outside of school hours.
• The practice’s uptake for the cervical screening programme was 71%, which was comparable to the CCG average of 69% and the national average of 74%.
• The practice offered one stop baby clinics for the ease of patients. Health visitor clinics, baby checks and immunisation clinics ran concurrently.

Updated 18 April 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.
• Patients aged over 75 years had a named GP responsible for their care. Those identified as being at high risk of admission and with complex care needs were prioritised for review.
• The practice held regular multi-disciplinary team meetings with district nurses, palliative care nurses and case managers to meet the needs of those at the end of life.
• The practice offered home visits and urgent appointments for those with enhanced needs.
• The premises were accessible to patients with mobility difficulties.
• Flu and shingles vaccinations were available at the practice for relevant patients. Information from the CCG told us that the uptake on flu vaccinations for patients over 65 years was higher than the CCG average.
• Health checks for patients over 75 years were offered at the practice.

Updated 18 April 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 located close to a University and had a relatively high number of students. The practice had attended events at the university to provide information about the practice to new students and raise awareness of meningitis.
• The practice offered online services as well as a full range of health promotion and screening that reflects the needs of this age group. This included NHS health checks, travel vaccinations, sexual health and family planning services.
• For the convenience of patients the practice offered extended opening hours on a Tuesday evening, telephone consultations and online booking for appointments. The practice also used texting to remind patients of their appointments.
• A self check in reduced the need for patients to queue at reception.

Updated 18 April 2016

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

• National reported data from 2014/15 showed that 76% of patients diagnosed with dementia had their care reviewed in a face to face meeting in the previous 12 months. This was below the CCG average of 82% and national average of 84%.
• National reported data from 2014/15 showed performance against mental health related indicators was 97% which was above the CCG average of 92% and the national average of 93%.
• Patients with poor mental health were offered annual reviews. Staff were aware of services available to signpost patients to further support. Information about healthy minds counselling services was also displayed in the waiting area.
• The practice was currently piloting a service with the community mental health team in which they emailed for advice about patients to improve communication between the services.
• As part of a CCG led scheme, the practice was starting to work with the Alzheimer’s Society to provide additional support and advice to patients with dementia and their families.

Updated 18 April 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 such as those with a learning disability.
• Patients with a learning disability were offered annual health reviews with the practice nurse and an opportunity to develop a patient passport that set out important information about them should they move between services.
• Practice staff told us that they would register patients at the practice with no fixed abode if they needed support but had not encountered this.
• The practice offered longer appointments for patients who needed them.
• The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people.
• 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.
• Support was available for those identified as carers. A carers pack which provided information about support was available to them.
• On site services including a weekly alcohol and drug clinic and the citizens advice bureau.