The Willow Tree Surgery

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence the service understood the needs of the people and communities it served and put them at the centre of how care was planned and delivered. We looked for evidence people accessed the care and treatment they needed.

At our last inspection with the previous provider, we rated this key question requires improvement. At this inspection, the rating has remained requires improvement.

People were involved in decisions about their care. The practice provided information people could understand. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to withdraw or not receive care.

However, we found people could not always access the care and treatment they needed when they needed it.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The practice had processes in place to make sure people were at the centre of their care and treatment choices. Staff decided, in partnership with people, how to respond to any relevant changes in people’s needs. Practice staff recognised the diverse population needs and fully understood their service’s demographic and language barriers. For example, social support incentives had recently been put in place to support the local community, such as a small food bank.

Patients we spoke with during our visit told us that during consultations staff listened to their concerns and preferences and agreed a plan of care together. Our review of clinical records showed people were supported to understand their condition, were involved in decisions about their care and in planning for their care needs. Care plans reflected physical, mental, emotional, and social needs of patients including those related to protected characteristics under the Equality Act.

The PPG were positive about the practice taking on board patient feedback and were assured any suggestions were taken seriously to improve patient care. Leaders encouraged feedback and information was available on the practice website for people to give feedback. We saw complaints were managed in line with the practice’s policy, and learning from them was evident. Staff were able to identify changes made because of patient feedback.

The practice had an exceptional understanding of the diverse health and care needs of its patient population and local community. This insight enabled the delivery of joined-up, flexible care that supported patient choice and ensured continuity. The practice worked closely with local asylum hotels, and staff had a deep awareness of the significant hardships and trauma many individuals had experienced, both in their daily lives and in their journeys to the United Kingdom.

The practice worked in partnership with other services to meet the needs of its patient population. For example, the practice was part of a Primary Care Network (PCN), which offered access to a range different healthcare professionals and health promotion incentives.

There were regular multidisciplinary meetings where partners including community mental health teams, were invited to the practice to help develop good working relationships. The practice had tailored its services to meet the diverse needs of its community, for example by building relationships with community groups to promote the uptake of screening programmes.

Practice staff supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. This also meant that the practice made sure that people were informed about to how to access their care records. People we spoke with did not raise any concerns in this area.

Information to promote screening and immunisation programmes were available in a range of languages. The practice had access to interpreter services, including British Sign Language. Information provided by the service met the Accessible Information Standard. A hearing loop was also available.

There were arrangements in place for people to know the name and role of the clinician they were seeing. We saw that a range of information on various aspects of health for all ages, and information about local support groups, was available on the practice website and notice board displays.

Practice leaders made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Information about making a complaint was available in the practice and on the practice website. We reviewed a sample of complaints and found they had been managed in line with the practice’s policy. Complaints had been acknowledged, investigated in a timely way, people were given an apology, and actions had been taken in response. People were also advised of the contact details of the Parliamentary Health Service Ombudsman if they wanted to escalate their complaint.

Learning from complaints was evident and staff were able to identify changes made because of patient feedback.

People who use the service, told us that they found it difficult to contact the practice, and when they had successfully made contact, there were no appointments available for them. This feedback was consistent with the results from the latest National GP Patient Survey.

The practice received scores below national and local averages in the National GP Patient Survey for questions linked to access. The percentage of respondents who were positive about their experience of contacting the practice was only 49%, which is below the expected average of 70%. The percentage of people who responded positively to how easy it was to contact their GP practice on the phone was only 23%, below the expected average of 53%.

Leaders had listened to this feedback and created an action plan to try to improve access. For example, the practice had implemented a new phone system which was being embedded to improve access. We received positive feedback about the new system from people who use the service and representatives we spoke with from the PPG. However, during our assessment we found that this was not fully effective, as there were not enough appointments available to meet patients’ needs. Although people were triaged and signposted to other services, people could not always access the care, support, and treatment they needed when they needed it directly from the practice.

Treatment rooms were available on the ground floor and automatic doors had been fitted in the building. There were 2 allocated disabled parking spaces at the back of the building, however, access from the car park into the practice was challenging for patients with limited mobility, as there was a step from the car park to the path. During our site visit, we observed a wheelchair user and their carer struggling to mount the high curb to access the practice.

Following our assessment the provider submitted further evidence surrounding access. This evidence showed that the practices access and experience metrics remained within the expected thresholds for appointments. In addition, the availability of appointments from June 2025 to November 2025 showed a positive trajectory.
Although, improving access for patients was becoming established, it required further embedding and was not yet effective.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Leaders proactively sought ways to address any barriers to improving people’s experience and worked with local organisations, including within the voluntary sector, to address any local health inequalities.

Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes.

There were processes in place to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. Staff used appropriate systems to capture and review feedback from people using the service, including those who did not speak English or have access to the internet.

We did not receive any concerns from patients specifically about planning for the future. People were supported to plan for important life changes, so they had enough time to make informed decisions about their future, including at the end of their life. Staff we spoke with understood the requirements of legislation when considering consent and decision-making.

There were systems in place to support and review vulnerable people, which included people who were housebound. The practice maintained a register of people living with cancer and people with palliative care needs. There were regular multidisciplinary team meetings where people receiving palliative care were discussed and reviewed appropriately.

We reviewed a sample of patient ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) decisions. People were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation. The decisions that we reviewed had been completed appropriately following national guidelines and we saw that information was shared with other services when necessary.