Care Quality Commission (CQC) inspectors have ordered major improvements in nine key areas at the practice run by GP Sunil Srivastava at the Richmond Medical Centre in Leeds, one of only five surgeries in the country to be so far given the bottom ranking as part of a bid to drive up standards.
The rating is particularly embarrassing for NHS England, which contracts GP services, as the practice is sited less than a mile from its headquarters.
If the practice fails to make improvements, it will be plunged into special measures - triggering the risk of closure.
Inspectors found its 2,200 patients faced long waits for the telephone to be answered, and long queues at the reception desk.
A survey found fewer than half of patients were seen within 15 minutes of their appointment time.
Inspectors said there were insufficient administrative staff, and only Dr Srivastava had undergone necessary employment, including criminal record, checks.
Patients could hear confidential details of others being discussed, while needles and dressings were found to be past their sterile date.
They said patients at the practice with long-term conditions were more likely to need emergency hospital admission and systems were not in place to follow-up children with high numbers of A&E visits or those with formal concerns over their welfare.
A report added: “The needs of the practice population were not clearly understood by staff and systems were not in place to effectively address identified needs.”
Inspectors did find the majority of patients they spoke to were complimentary about care and urgent appointments were usually available on the day requested. But the most recent patient survey found only 60 per cent would recommend the surgery to others.
Sue McMillan, deputy chief inspector of general practice for the CQC, said: “The areas of concern, such as the failure to undertake employment checks, that have been identified in the report will need to be addressed and immediate action taken so that people get safe, high-quality and compassionate primary care.
“Dr Srivastava has acknowledged that he must take action to address the specific issues we have identified. If in the coming months we don’t see sufficient improvement, we may have to consider a package of further measures to ensure that this practice delivers the care and treatment to a standard that we all expect.”
Matt Ward, chief operating officer for NHS Leeds South and East Clinical Commissioning Group, said it was working with the practice and NHS England to deliver improvements.
Dr Srivastava said many of the criticisms focused on non-clinical and administrative issues and he was confident improvements would be made to meet required standards.