The White House Surgery

Updated 23 January 2017

The White House Surgery is located in a converted house in Barking within a residential area. The practice is a part of Barking and Dagenham Clinical Commissioning Group.

There are 5000 patients registered at the practice with 10% higher than the national average of patients aged 25 to 39.

The practice has one male and two female GP partners carrying out 20 sessions per week, three regular locums GP’s carrying out up to 10 sessions per week. Two practice nurses completing 15 sessions per week and a health care assistant completing two sessions per week. The practice also has a practice manager partner, an assistant practice manager, a pharmacist and 10 reception/administration staff members.

The practice is a GP training practice for first, second and fourth year GP registrars.

The practice operates under a General Medical Service Contract (GMS) (a contract between NHS England and general practices for delivering general medical services and is the commonest form of GP contract).

The practice is open between 8:30am and 6:30pm and once a month on a Saturday between 9:00am and 1:00pm. Phone lines are answered from 8:30 am and appointment times are as follows:

• Monday 9:00am to 12:20pm and 3:00pm to 5:15pm

• Tuesday 9:00am to 11:50am and 3:00pm to 5:30pm

• Wednesday 9:00am to 11:50am and 3:00pm to 5:30pm

• Thursday 9:00am to 12:20pm Doors closed at 1:00pm

• Friday 9:00am to 11:30am and 3:30pm to 5:50pm

• One Saturday a month 9:00am to 1:00pm

The out of hour’s provider covers calls made to the practice whilst it is closed.

The White House Surgery operate regulated activities from two locations and is registered with the Care Quality Commission to provide treatment of disease, disorder or injury, diagnostic and screening procedures, family planning and surgical procedures. The branch site (The Green House Surgery) is located at 37 Cavendish Gardens, Barking, IG11 9DU; this site was not visited as a part of the inspection.

Updated 23 January 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The White House Surgery on 28 June 2016 and 14 July 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.
• 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 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.
• 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, an annual staff survey was carried out 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:

• Review how patients with caring responsibilities are identified and recorded on the clinical system to ensure information, advice and support is made available to them.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 23 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.

• The percentage of patients on the diabetes register with a record of a foot examination and risk classification in the preceding 12 months was 94% compared with a national average of 88%.

• 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 23 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. 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.

• 77% of women aged 25 to 64 had a record of a cervical screening test documented in their record in the preceding five years compared to 82% nationally.

• 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.

Updated 23 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.

• The practice was a part of the Everyone Counts Scheme, which focuses on patients aged over 75 years old.

Updated 23 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 opened once a week on a Saturday for working patients who were unable to attend the practice during the week.

• The practice increased the number of telephone consultations and changed the times they were available to meet patients requirements.

Updated 23 January 2017

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

• 75% of patients diagnosed with dementia who had their care reviewed in a face to face meeting in the last 12 months, which is comparable to the local and national average of 84%.

• The percentage of patients with Schizophrenia, bipolar affective disorder and other psychoses who had an agreed care plan documented in the record was 91% compared with the national average of 88%.

• 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.

• Alerts were put on the system to identify these patients so they received priority appointments.

Updated 23 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 homeless people and those with a learning disability.

• Patients received priority appointments.

• 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.