Hereford Medical Group Also known as HMG

Updated 19 February 2015

Moorfield House Surgery provides a primary medical service to patients who live within the city of Hereford. The practice has estimated that that majority of its patients speak English.

The practice has five GP partners and four salaried GPs. It is a training practice and when we visited, a GP registrar was undertaking their specialist training to become a GP there. The practice employed five nurses and two healthcare assistants. Overall there was a balance in the gender of the clinicians. A practice manager and a deputy practice manager led the team of ten reception and administrative staff.

We visited Moorfield House Surgery at 35 Edgar Street, Hereford. The practice also has two branch surgeries at: 15 Aylestone Hill, Hereford and at Ross Road, Hereford. No concerns had been raised with us about the branch surgeries and we did not go to them during our inspection.

The practice does not provide out of hours services for its patients. Full information was available for patients on-line and in the practice leaflet and if patients called the practice when it was closed, there was an answerphone message giving the telephone number they should ring depending on the circumstances.

The GPs at Moorfield House Surgery together with other GPs across the Herefordshire CCG area owned and managed an extended hours service. Patients were able to book appointments with this service from the practice.

Updated 19 February 2015

Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection of this practice on 15 October 2014.

The practice has a main surgery and two branch surgeries. We did not include the branch surgeries in this inspection.

We have rated this practice as ‘good’ overall. We found the practice to be ‘good’ in the safe domain, the effective, caring, responsive and well-led domains. We found the practice provided good care to older people; people with long term conditions; families, children and young people; the working age population and those recently retired; people in vulnerable circumstances and people experiencing poor mental health.

Our key findings were as follows:

• The practice had clear and thorough systems to monitor safety. They ensured that any information arising from complaints or significant events was shared so that staff could learn them and improve the service for patients.

• The systems in place at the practice to manage medicines and to ensure infection control were clear, robust and thorough.

• Patients were positive about the care and treatment they received.

• The practice team understood the needs of their patient population. They offered appointments at times which were convenient to patients and they worked flexibly as a team to ensure patients’ health needs were met.

• The practice had created a ‘learning culture’ which involved all members of the practice team and ensured that patients continually benefitted from high levels of care and treatment.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

Updated 19 February 2015

The practice is rated as good for the care of people with long-term conditions. There were emergency processes in place and referrals were made for patients whose health deteriorated suddenly. Longer appointments and home visits were available when patients needed them. All these patients had a named GP and a structured annual review to check that their health and medication needs were being met. For those people with the most complex needs, the named GP worked with relevant health and care professionals to deliver a multidisciplinary package of care.

Updated 19 February 2015

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. Immunisation rates were relatively high for all standard childhood immunisations. Appointments were available outside of school hours and the premises were suitable for children and babies. There were good examples of joint working with health visitors. Emergency processes were in place and referrals were made for children and pregnant women whose health deteriorated suddenly.

Updated 19 February 2015

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 and provided a range of services, for example, in dementia and end of life care. It was responsive to the needs of older people, and offered home visits and rapid access appointments for those with complex needs.

Updated 19 February 2015

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 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 19 February 2015

The practice is rated as good for the care of people experiencing poor mental health, including people with dementia. The practice regularly worked with multi-disciplinary teams to support patients experiencing poor mental health. Staff had received training on how to care for people with mental health needs and dementia and provided appropriate information for them or referred them to other teams. The GPs referred to themselves as ‘advocates’ for their most vulnerable patients.

Updated 19 February 2015

The practice is rated as good for the care of people whose circumstances may make them vulnerable. The practice held a register of patients who needed end of life care and offered these patients a caring and compassionate service. The practice held a register of patients with a learning disability. It had set up systems for carrying out annual health checks for this group and was about to start these checks.

The practice regularly worked with multi-disciplinary teams in the case management of vulnerable people. It provided information about how to access various support groups and voluntary organisations. 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.