This practice is rated as Good overall. (A previous inspection undertaken on 28 October 2014 had rated the practice as Good overall.)

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Outstanding

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

As part of our inspection programme, we carried out an announced comprehensive inspection at Moorfield House Surgery on 14 June 2018.

At this inspection we found:

• The practice had clear governance policies and protocols, which were accessible to all staff. There were clear systems in place to manage risk so that safety incidents were less likely to happen. When incidents did happen, the practice learned from them and improved their processes. For example, in relation to their recall system regarding high-risk medicines. This system had subsequently been shared with other local practices as best practice.
• Patient care and treatment was delivered in line with up to date best practice guildance. There was evidence of quality improvement within the practice. Clinicians knew how to identify and manage patients with severe infections including sepsis.
• The practice was proactive in engaging with patients to encourage and support them to attend for reviews of their care needs and treatment.
• The practice had achieved 100% (559) of the total Quality and Outcomes Framework indicators. This was higher than local and national figures (530 and 539 respectively).
• The practice offered patients a range of access to appointments, such as telephone consultations and extended hours. Patients also had access to Saturday morning appointments via a local ‘hub’.
• Uptake rates for cancer screening programmes were higher than local and national averages.
• The practice were engaged with innovative schemes to support quality patient care and service delivery.
• Patients where overwhelmingly positive about the service, care and treatment they received at the practice.
• The practice had been acknowledged as the second highest practice in Leeds for patient satisfaction (using the national GP patient survey results).
• There was evidence of a cohesive team with a strong focus on continuous learning and improvement at all levels of the organisation.

We saw areas of outstanding practice:

• As a result of a significant incident, a template had been developed regarding the review of patients who were prescribed high risk medicines. This template had subsequently been shared with, and in the process of being adopted by, other local practices.
• The practice were proactive in identifying and supporting patients who were experiencing domestic abuse. They worked with the local police to raise awareness and support patients in disclosing their experiences of being abused. This had resulted in an increase in patients feeling able to discuss their experiences. Their work in this area had been presented both at a local and national level.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

Letter from the Chief Inspector of General Practice

We inspected Moorfield House Surgery on the 28th October 2014 as part of our new comprehensive inspection programme. Our inspection team was led by a CQC Inspector and included a GP specialist advisor and a practice manager specialist advisor. 

We have rated the practice as good.

Our key findings were as follows:

• Patients were highly complementary about the staff and the care and treatment they received.
• Staff understood the importance of raising concerns and reporting incidents.
• There was a systematic approach to clinical audits and learning from the findings.
• Patients were treated with courtesy and respect and felt involved in their diagnosis and treatment.
• Patients were able to get an appointment convenient for them.
• The practice sought and acted upon feedback from staff and patients.
• There was an open and supportive culture which encouraged high standards.

We saw areas of outstanding practice including:

• The care of patients with long term conditions.
• The joint working with care homes and social services in the care of vulnerable elderly patients.

However, there were also areas of practice where the provider needs to make improvements. 

In addition the provider should:

• Minutes of practice meetings did not include details of any significant events which had been discussed. Whilst significant events were investigated and reported to the local Clinical Commissioning Group there was no up to date practice record to aid staff in identifying patterns or themes.

• Medicine storage cupboards were not secured by key locks and there was no system to restrict access only to authorised staff.

• There was no system to record the serial numbers of prescription pads issued to the doctors.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice