White Rose Surgery

Updated 22 November 2022

White Rose Surgery is located in South Elmsall, Wakefield at:

Exchange Street,

South Elmsall,

Pontefract,

West Yorkshire.

WF9 2RD

This site was visited as part of this inspection.

The provider of the service White Rose Surgery operates two locations registered separately with the Care Quality Commission. White Rose Surgery, which is the subject of this inspection, and another practice, Rycroft Primary Care Centre which operates from Madeley Road, Havercroft, Wakefield, West Yorkshire, WF4 2QG. This latter practice does not form part of this inspection. Both practices share the same patient list, and have unified data in relation to patient outcomes. Patients from White Rose Surgery can access a gym and wider health and wellbeing support at Rycroft Primary Care Centre.

The provider is registered with CQC to deliver the following Regulated Activities at this location; diagnostic and screening procedures, maternity and midwifery services, family planning, and treatment of disease, disorder or injury and surgical procedures.

The practice is situated within the Wakefield District Health & Care Partnership, of the NHS West Yorkshire Integrated Care Board. White Rose Surgery delivers Personal Medical Services (PMS) as part of a contract held with NHS England. White Rose Surgery and the practice at Rycroft Primary Care Centre deliver care to a patient population of around 23,600, with White Rose Surgery having primary responsibility for around 15,000 of these patients.

The practice is part of a wider network of GP practices as part of the Wakefield Health Alliance South. This comprises a partnership of GP practices who work together to improve patient care within their locality.

Information published by Public Health England shows that deprivation within the White Rose Surgery and Rycroft Primary Care Centre population group is in the second lowest decile (two of 10). The lower the decile, the more deprived the practice population is relative to others.

According to the latest available data, the ethnic make-up of the White Rose Surgery and Rycroft Primary Care Centre is 98.4% White, 0.5% Asian, 0.7% Mixed,0.3% Black and 0.1% Other.

The two practices have a higher than national average prevalence for certain conditions including asthma, chronic obstructive pulmonary disease (COPD), depression, diabetes and obesity.

There are 5 GP partners (2 male/3 female) who work at the practice and 1 regular locum GP (male)). There are 4 advanced care practitioners (ACPs) (1 male/3 female) 1 of whom is also a partner, 1 trainee ACP (female), 3 practice nurses (female), 2 health care assistants (female), and a pharmacy technician (female). Other clinical resource is provided to the practice from their primary care network (PCN). This includes a clinical pharmacist, 2 trainee nursing assistants, a first contact physiotherapist, and 2 wellbeing coordinators. Supporting these staff is a reception and administration team led by a practice manager, and administration and reception leads. The practice is accredited as a GP training centre supporting doctors training to specialise in general practice.

The practice is open (including in-house extended hours) between 7am and 6.30pm Monday to Friday. The practice offers a range of appointment types including urgent appointments, book on the day appointments, telephone consultations, online consultations, and home visits.

Additional extended access is provided for patients, where late evening and weekend appointments are available at other practices in the Wakefield area. Appointments for these services are available 3pm to 9.30pm Monday to Friday, 9am to 4pm Saturdays, and 9am to 1pm Sundays. Out of hours services are provided by Local Care Direct Limited.

Updated 22 November 2022

We carried out an announced comprehensive inspection at White Rose Surgery on 19 and 20 October 2022. Overall, the practice is rated as good, and as follows for the key questions:

Safe – good

Effective - good

Caring - good

Responsive - outstanding

Well-led - good

At the previous inspection in September 2015 the practice was rated as outstanding overall, with individual ratings of outstanding for providing effective and responsive services.

At this inspection, the practice has been rated as good for the provision of effective services and and outstanding for the provision of responsive services. Effective is rated as good because since the 2015 inspection some elements recognised as outstanding have been mainstreamed into general practice nationally. Whilst the provider had maintained this good practise, the threshold to achieve an outstanding rating had not been reached for this key question.

We have rated responsive as outstanding due to the provision of a dedicated community long-term conditions nurse led service who dealt with the care of housebound patients, the delivery of enhanced screening for certain long-term conditions prevalent in the community, and high patient satisfaction levels in relation to services provided.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for White Rose Surgery on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this comprehensive inspection in line with our inspection priorities, due to the length of time since the last inspection.

How we carried out the inspection

This inspection was carried out in a way which enabled us to spend a minimum amount of time on site.

This included:

• Conducting some staff interviews using video/telephone conferencing.
• Completing clinical searches on the practice’s patient records system and discussing findings with the provider.
• Reviewing patient records to identify issues and clarify actions taken by the provider.
• Requesting evidence from the provider.
• A site visit to location.
• Reviewing completed staff questionnaires.
• Speaking with a patient and reviewing their feedback.

Our findings

We based our judgement of the quality of care at this service on a combination of:

• what we found when we inspected
• information from our ongoing monitoring of data about services and
• information from the provider, patients, the public and other organisations.

We have rated this practice as good overall.

We found that:

• Patients received effective care and treatment that met their needs.
• Staff dealt with patients with kindness and respect and involved them in decisions about their care.
• There were systems in place to safeguard children and vulnerable adults from abuse. Staff we spoke with knew how to identify and report safeguarding concerns.
• There was a programme of quality improvement, this included clinical audit and monitoring prescribing performance.
• The practice supported staff development, and was an accredited training practice for GP trainees.
• Staff informed us that they had access to policies, procedures and guidance relevant to their role and responsibilities, this included clinical protocols and guidance.
• The provider had appropriate clinical equipment in place to enable the effective assessment of patients. The provider also had the necessary equipment and medicines available to deal with medical emergencies including emergency resuscitation equipment.
• The practice operated effective systems and processes to ensure good governance in accordance with the fundamental standards of care. Business planning had been undertaken and we saw that progress against this was monitored.
• The management team in the practice demonstrated they had the capacity and skills to deliver high-quality, sustainable care.
• The practice hosted several staff from their Primary Care Network (PCN) who delivered services at the location and at other locations operated by the provider.

We saw an area of outstanding practice:

• The practice had developed a community long-term conditions service for housebound patients, staffed by a specialist nurse. We saw evidence which indicated that this, and the advanced care practitioner led acute home visiting service, had contributed to reduced attendances at local urgent and emergency care services.

Whilst we found no breach of regulations, the provider should:

• Make improvements to increase the uptake of cervical screening.
• Formalise clinical supervision practices for non-medical prescribers.
• Follow best practice guidance in the management and monitoring of people on high risk medicines, and those with long-term conditions.
• Establish the vaccination status of staff working in the practice in line with current guidance.
• Establish a patient participation group to improve patient engagement and feedback routes.

Details of our findings and the evidence supporting our ratings are set out in the evidence tables.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services