Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at White Rose Surgery on 2 September 2015. Overall the practice is rated as outstanding.

We specifically found the practice to be outstanding for providing effective services to older people and people with long term conditions. Also outstanding for providing responsive services to older people, people with long term conditions and people whose circumstances may make them vulnerable

Our key findings across all the areas we inspected were as follows:

• Patients’ needs were assessed and care was planned and delivered following best practice guidance. Staff had received training appropriate to their roles.
• Staff understood and fulfilled their responsibilities to raise concerns and to report incidents, near misses and any identified safeguarding issues. There was a clear leadership structure and staff felt supported.
• Risks to patients were assessed and well managed.
• The practice had good facilities and was well equipped to treat and meet the needs of patients.
• Information about services and how to complain was available and easy to understand.
• Urgent appointments were available for patients the same day as requested, although not necessarily with a GP of their choice.
• Patients said they were treated with compassion, dignity and respect and were involved in care and decisions about their treatment.
• The practice sought patient views how improvements could be made to the service, through the use of patient surveys, friend and family test and the patient participation group.

We saw several areas of outstanding practice:

• The practice routinely screened for chronic obstructive pulmonary disease (COPD) in all patients who were smokers and aged 40 and above; irrespective of any apparent symptoms. This had resulted in a higher than average prevalence of COPD for the practice. As a result of these interventions the practice could evidence a 26% reduction in COPD hospital admissions in the previous 12 months.

• The practice had an in-house smoking cessation service which was facilitated by a trained member of staff. Through interventions and support offered they could evidence the number of patients who had stopped smoking during the previous 12 months. This had resulted in a 16% reduction of registered smokers.

• The practice had employed a nurse who specifically focused on house bound patients who either had a long term condition or were elderly. Through targeted interventions, this had resulted in an overall reduction of unplanned hospital admissions in the previous 12 months, 30% of which were patients who were over the age of 80.

• There was a fully equipped gym located in the practice, with qualified gym instructors to assist patients in improving their mobility, managing body weight and maintaining a healthy lifestyle. This was available to all patients who were registered with the practice.

• The practice leaflet and other health care advice/information had been translated into Polish to support the 10% of registered patients who were Polish speaking

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice