Dr Qazi Jehangir Also known as Dr Q M Jehangir General Medical Practice Ltd

Updated 16 January 2017

Dr Qazi Jehangir is a single-handed practice which was established in 1980 and moved to its current location approximately 10 years ago. Dr Qazi Jehangir is located in Yarnspinners Primary Health Care Centre in Nelson East Lancashire BB9 7SR. The Health Centre is owned by Community Health Partnership (CHP) and is maintained and serviced by NHS Property Services Ltd. The site also hosts four other practices and a variety of community services including podiatry, dietician and health visitor clinics.

The practice is part of the NHS East Lancashire Clinical Commissioning Group (CCG) and provides services to approximately 2700 patients under a General Medical Services (GMS) contract with NHS England.

The average life expectancy of the practice population is slightly lower than local and national averages (80 years for females, compared to the local average of 81 and national average of 83 years, 76 years for males, compared to the local average of 77 and national average of 79 years).

The age distribution of the total practice’s patient population shows the practice has a higher percentage of patients under the age of 18 years (30%) when compared to CCG and national averages (22% and 21% respectively). The practice also has a lower percentage of patients over the age of 65 years (12%) when compared to the CCG and national averages (18% and 17% respectively).

The practice has a higher percentage of patients experiencing a long-standing health condition when compared to CCG and national averages (65% compared to the CCG and national averages of 58% and 54% respectively). The proportion of patients who are in paid work or full time education is lower (53%) when compared to the CCG average of 57% and national average of 62% and the proportion of patients with an employment status of unemployed is 12% which is higher than the CCG average of 6% and the national average of 5%.

Information published by Public Health England rates the level of deprivation within the practice population group as one on a scale of one to ten. Level one represents the highest levels of deprivation and level ten the lowest.

Dr Qazi Jehangir (male) provides full time GP cover at the practice and a locum GP (female) regularly undertakes two sessions per week. In addition the practice employs one practice nurse, one practice pharmacist and one healthcare assistant. Clinical staff are supported by a practice manager and three administration and reception staff.

The practice is open between 8am and 6.30pm Monday to Friday. However, the practice closes at 1pm on Tuesday although the GP remains on call until 6.30pm. Appointments are also available during extended hours from 6.30pm to 8pm on a Monday.

Outside normal surgery hours, patients are advised to contact the out of hours service by dialling NHS 111, offered locally by the provider East Lancashire Medical Services.

Updated 16 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Qazi Jehangir on 14 December 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 a system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed.
• 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.
• 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 was available and easy to understand.
• Limited information about how to complain was made available to patients and we noted the information did not include reference to the Parliamentary Health Service Ombudsman. However, there were systems and processes in place to ensure improvements were made to the quality of care as a result of complaints and concerns.
• Patients said they found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments 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 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 improvement are:

• Provide patients with clear information about how to make a complaint and include details of the Parliamentary Health Service Ombudsman.

• Develop a programme to support quality improvement activity.

• Develop a locum information pack.

• Review and update practice information made available to patients via the NHS choices website.

• Consider the development of an equipment inventory to support calibration and testing activity.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 16 January 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.

• Performance for diabetes related indicators was between 78% and 100% and this was higher than the national average range of 70% to 95%.

• Longer appointments and home visits were available when needed. We were told the practice coordinated appointments to reduce the need for patients to visit the surgery on more than one occasion.

• 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 16 January 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.

• Patients told us that children and young people were treated in an age-appropriate way and were recognised as individuals.

• Cervical screening uptake for women aged 25-64 years was 82%, which was comparable to the CCG average of 83% and national average of 81%.

• 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. For example a representative of the health visiting team held weekly meetings with practice staff.

Updated 16 January 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.

• Longer appointments were offered to patients aged over 75 years.

• We were told the practice was currently involved in a pilot scheme that offered the use of telemedicine in care homes and allowed carers to speak directly with health professionals.

Updated 16 January 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 used a fully automated text and email messaging service designed to reduce missed appointments and increase planned attendance at clinics.

• The practice offered extended hours appointments for patients unable to attend the surgery during normal opening hours.

Updated 16 January 2017

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

• 100% of patients diagnosed with dementia had had their care reviewed in a face to face meeting in the last 12 months, which was higher than the national average of 84%.

• 94% of patients with schizophrenia, bipolar affective disorder and other psychoses had a comprehensive care plan documented in the preceding 12 months, which was higher than the national average of 89%.

• A record of alcohol consumption was recorded for 100% of patients with mental health related conditions compared to 89% nationally.

• 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 16 January 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 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.