The White House Surgery

Updated 9 March 2017

The White House Surgery was previously registered with care quality commission as Dr Watton and Dr Kennedy and Dr Hopkins and Dr McDonough. The practice is located in a purpose built health centre in the S2 district of Sheffield and accepts patients from the Manor and Woodthorpe area. Public Health England data shows the practice population has a higher than average number of young patients aged 0-40 years compared to the England average and the practice catchment area has been identified as one of the first most deprived areas nationally.

The practice provides General Medical Services (GMS) under a contract with NHS England for 6217 patients in the NHS Sheffield Clinical Commissioning Group (CCG) area. It also offers a range of enhanced services such as minor surgery and childhood vaccination and immunisations.

The practice has four GP partners (three female, one male), one male salaried GP, two practice nurses, three healthcare assistants, practice manager and an experienced team of reception and administration staff. The practice manager is new to post in August 2016. The practice is a teaching and training practice for medical students, foundation two doctors, GP registrars, nurses and physician assistants. 

The practice is open 8.15am to 6pm Monday to Friday with the exception of Thursdays when the practice closes at 1pm. The GP Collaborative provides cover when the practice is closed on a Thursday afternoon.  Morning and afternoon appointments are offered daily Monday to Friday with the exception of Thursday afternoon when there are no afternoon appointments. Extended hours are offered on alternate Saturday mornings 8.30am to 11am with a GP and early morning appointments are offered 7.30am to 8am  with a GP, nurse and healthcare assistant two mornings a week when the practice does not have a Saturday morning clinic. The practice also offers telephone consultations with a GP on a Monday evening 6.30pm to 7pm. 

When the practice is closed between 6.30pm and 8am patients are directed to contact the NHS 111 service. The Sheffield GP Collaborative provides cover when the practice is closed between 8am and 6.30pm. For example, 6 – 6.30pm. Patients are informed of this when they telephone the practice number.

As part of the Care Quality Commission (Registration) Regulations 2009: Regulation 15, we noted at the comprehensive inspection on 8 June 2016 that the GP partners registered with the Care Quality Commission as the partnership did not reflect the GP partners at the practice. We noted at the focused inspection on 3 February 2017 that the registration had been updated to reflect the current partners in the practice.

Updated 9 March 2017

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The White House Surgery (previously registered as Dr Watton and Dr Kennedy and Dr Hopkins and Dr McDonough) on 8 June 2016. The overall rating for the practice was good with requires improvement for safe. The full comprehensive report from 8 June 2016 can be found by selecting the ‘all reports’ link for White House Surgery on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 3 February 2017 to confirm that the practice had carried out their action plan to meet the legal requirements in relation to the breach in regulation that we identified in our previous inspection on 8 June 2016. This report covers our findings in relation to those requirements and also additional improvements that the practice have made since our last inspection.

Overall the practice is rated good. Specifically, following the focused inspection we found the practice to be rated good for providing safe services.

Our key findings were as follows:

• Appropriate recruitment checks had been undertaken, prior to employment, for locum doctors used by the practice since the comprehensive inspection on 8 June 2016.

• The practice had completed a fire evacuation drill on 1 February 2017 and there was a plan to do this annually as a minimum as specified in their fire risk assessment.

• A policy had been implemented and risk assessment completed for legionella (Legionella is a term for a particular bacterium which can contaminate water systems in buildings).

• Significant events were analysed and had been discussed with the full practice team to improve staff learning.

• The practice had appointed a designated person to receive and action safety bulletins and alerts. A log of the actions taken had been implemented. to monitor the appropriate actions had been taken by the practice.

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Professor Steve Field CBE FRCP FFPH FRCGP 

Chief Inspector of General Practice

Updated 25 July 2016

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

• Nursing staff had lead roles in long term condition management and patients at risk of hospital admission were identified as a priority.

• 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. For example, the practice hosted meetings with the local Professor of clinical diabetes for patients of the practice and local practices to discuss patients with complex needs.

Updated 25 July 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.

• The practice proactively coded children and young people who were vulnerable so staff were alerted of a patient’s situation and needs.

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

• QOF data showed 76% of women eligible for a cervical screening test had received one in the previous five years compared to the national average of 82%.

• The practice displayed posters in the patient toilets on sensitive issues. For example, domestic violence.

• 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 and health visitors.

Updated 25 July 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.

• The practice provided medical care and weekly routine GP visits to patients who resided in a local care home.

• The percentage of patients aged 65 or over who received a seasonal flu vaccination was 78%, higher than the national average of 73%.

Updated 25 July 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 offered appointments to patients who could not attend during normal opening hours at the practice one Saturday morning a month and three hours each week at either early morning or late evening clinics, the day and times alternated each week. It also offered weekend and evening appointments at one of the four satellite clinics in Sheffield, in partnership with other practices in the area through the Prime Minister’s Challenge Fund.

• The practice offered appointments at the practice with the Occupational Health Advisory service.

• 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.

Updated 25 July 2016

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

• Of those patients diagnosed with dementia, 89% had received a face to face review of their care in the last 12 months, which was higher than the national average of 84%.

• Of those patients diagnosed with a mental health condition, 90% had a comprehensive care plan reviewed in the last 12 months, which was higher than the national average of 88%.

• The practice regularly worked with multidisciplinary teams in the case management of patients experiencing poor mental health, including those living with dementia.

• The practice carried out advance care planning for patients with dementia.

• The practice had advised 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.

• The practice hosted Improving Access to Psychological Therapies Programme (IAPT) to support patients’ needs.

Updated 25 July 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 those with a learning disability.

• The practice provided a weekly surgery at a local hostel for the homeless as part of a locally commission service.

• The practice regularly worked with other health care professionals in the case management of vulnerable patients. For example, local alcohol and drug misuse services.

• The practice informed vulnerable patients about how to access various support groups and voluntary organisations. The practice was part of the Sheffield Healthier Communities Project, a health improvement programme to support patients by offering health trainers and patient advocates.

• The practice hosted a community support worker who would advise and signpost patients to services. For example, information on housing and social care or support to join local social activities.

• 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.

• The practice held weekly multidisciplinary team meetings with the practice staff and local community staff, for example, district nurses to discuss patients whose circumstances may make them vulnerable.