The Care Quality Commission
  • Doctor
  • GP practice

Dr Watson & Partners Also known as The Friarwood Surgery

Overall: Good read more about inspection ratings

Carleton Glen, Pontefract, West Yorkshire, WF8 1SU (01977) 704777

Provided and run by:
Dr Watson & Partners

All Inspections

1 December 2023

During a routine inspection

We carried out an announced comprehensive inspection at Dr Watson & Partners on 30 November and 1 December 2023. Overall, the practice is rated as good, with most key questions rated good other than responsive which was rated as requires improvement.

Safe – good.

Effective – good.

Caring – good.

Responsive – requires improvement.

Well-led – good.

At the last inspection on 24 September 2015, we rated the practice as outstanding overall, and for the key questions of effective and responsive. This was because:

  • Systems were in place to ensure clinicians were kept up to date with guidelines and that guidelines had positively influenced and improved patient outcomes. In addition, the practice had used innovative and proactive methods to improve patient outcomes.
  • The practice had initiated service improvements for patients above their contractual obligations. It had reviewed the needs of their patient population to secure service improvements to meet these. In addition, patients told us it was easy to access appointments.

At this inspection, we found that those areas previously regarded as outstanding were now generally embedded throughout other GP practices. Whilst the provider had maintained this good practice, the threshold to achieve an outstanding rating had not been reached. In addition, we saw that patient satisfaction regarding access and appointments had shown significant deterioration since 2020/21. We recognise the pressure that practices are currently working under, and the efforts staff are making to maintain levels of access for their patients. At the same time, our strategy makes a commitment to deliver regulation driven by people’s needs and experiences of care. Although we saw the practice was attempting to improve access, this was not yet reflected in the GP patient survey data or other sources of patient feedback. Therefore, the rating for responsive was requires improvement, as ratings depend on evidence of impact and must reflect the lived experience that people were reporting at the time of inspection.

The practice is therefore now rated good overall.

The full reports for previous inspections can be found by selecting the ‘all reports’ link for Dr Watson & Partners on our website at www.cqc.org.uk

Why we carried out this inspection

We carried out this inspection due to the length of time since our 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 staff interviews using video and telephone conferencing.
  • Completing clinical searches on the practice’s patient records system (this was with consent from the provider and in line with all data protection and information governance requirements).
  • Requesting evidence from the provider.
  • A short visit to the provider site.
  • Staff questionnaires
  • Requesting feedback from patients via the ‘share your experience’ link on the CQC website.

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 found that:

  • The practice provided care in a way that kept patients safe and protected them from avoidable harm.
  • The provider had a programme of quality improvement activities in place which included clinical and non-clinical audits.
  • The practice had undertaken several service improvement changes, such as those related to handling test results and document management.
  • Child immunisation performance was mostly above national targets.
  • Staff dealt with patients with kindness and respect, and involved them in decisions about their care.
  • Patient feedback in relation to accessing services was mixed. National GP Patient Survey results in relation to access had shown deterioration over recent years. In response to this the provider had taken actions to improve access, but these had yet to be fully embedded and give defined outcomes in patient feedback.
  • Staff feedback regarding working at the practice at all levels was positive. In addition, the provider had taken steps to focus on the improvement of staff wellbeing.
  • The way the practice was led and managed promoted the delivery of high-quality, person-centre care.

We saw areas of outstanding practice:

  • Practice staff had organised and delivered a Halloween themed event to promote the take up of the child nasal flu vaccine.
  • The provider had undertaken service reviews, and implemented activities and process changes to increase clinical capacity, and improve access to, and effectiveness of, services.

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

  • Address minor concerns regarding medicines monitoring and long-term conditions management identified during the inspection.
  • Work to continue to improve cervical screening rates.
  • Continue actions to improve patient satisfaction in relation to access and their appointment system.

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 Health Care

24 September 2015

During a routine inspection

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Dr Watson & Partners on 24 September 2015. Overall the practice is rated as outstanding.

Please note that when referring to information throughout this report, for example any reference to the Quality and Outcomes Framework data, this relates to the most recent information available to the CQC at that time.

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.
  • There were systems in place to reduce risks to patient safety, for example infection prevention and control procedures and health and safety assessments.
  • Staff understood and fulfilled their responsibilities to raise concerns and to report incidents, near misses and any identified safeguarding issues.
  • Information about services and how to complain was available and easy to understand.
  • The practice sought patient views on how improvements could be made to the service, through the use of patient surveys family and friends test and via the practice’s patient participation group (PPG).
  • Urgent appointments were available for patients the same day.
  • Patients said they were treated with compassion, dignity and respect and were involved in care and decisions about their treatment.
  • Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
  • Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
  • The practice worked closely with other organisations and with the local community in planning how services were provided to ensure that they meet people’s needs.
  • The practice had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand
  • The practice had a clear vision which had quality and safety as priority. A business plan was in place and was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all practice staff with evidence of team working across all roles.

We saw several areas of outstanding practice including:

  • We saw that the practice was responsive to the needs of the local population. For example, the practice had increased the flexibility of access to appointments and could demonstrate the impact of this by reduced use of the out of hours and secondary acute service and very positive patient survey results. We saw that in response to patients’ feedback they had looked at innovative ways to improve access with a ‘24 hour interactive telephone system’ where patients could book an appointment with their chosen GPs (for appointments within surgery hours) at any time over a twenty four hour period seven days a week. Fifty percent of the available appointments for the practice were available in this way.
  • The practice had a very good skill mix which included advanced nurse practioners (ANP) who provided daily visits and support to a local nursing care home for those with a high need for medical care. The impact was to reduce unplanned hospital admissions and allowed for more effective use of GP hours.
  • The practice provided comprehensive screening and regular reviews for patients at risk of developing long term conditions. The practice supported individuals with a named nurse and regular telephone consultancy to aid self-management of their condition. Long term conditions were regularly monitored and recalls made. Patients with diabetes had access to a consultant diabetologist at the practice.
  • The practice has been innovative in its efforts to meet the needs of more patients. It employs ANPs and Physician Assistants and this enables the practice to offer an appointment system that is flexible to the health needs of patients. There is also an effective mentorship programme that supports these additional roles within the practice.
  • The practice provided a weekly link for patients with mental health needs to access ‘Right Steps’ support sessions. This is part of improving access to psychological therapies (IAPT) scheme. Patients can self-refer into the service in order to receive support promptly.
  • The practice monitored accident and emergency (A&E) attendance daily and directly contacted patients who had attended A&E to review where access to their service could improve.
  • The practice contacted ‘carers’ to offer individual support and direct them to additional services.
  • The practice held a weekly dedicated Dementia ‘memory’ clinic. All staff and the PPG had received dementia training.
  • The practice had a health trainer to support weight management, alcohol reduction and smoking cessation and could demonstrate this had a positive impact for patients using this service.
  • The practice offered enhanced services including a prostate clinic and bladder scanning service, joint service and in-house physiotherapy, audiology and ultrasound services.
  • The practice looked at organisational values and future visions in monthly staff meetings and organised team ‘away days’ to promote ideas and team development.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice