The Green Practice

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We looked for evidence that service leadership, management and governance assured high-quality, person-centres care; supported learning and innovation and promoted an open, fair culture.

At our last assessment in November 2025, we rated this key question as requires improvement. The service was in breach of legal regulation in relation to good governance for which a warning notice was issued. At this assessment in July 2026, the practice had made significant improvements and is no longer in breach of regulation 17 related to good governance. We focused the assessment of this key question on 4 quality statements. The overall rating for this key question has changed from requires improvement to good.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities. At the last assessment in November 2025, we found that the leaders did not ensure people were adequately informed of activities that could improve service delivery. At this assessment in July 2026, we found that improvement had been made to how the PPG meetings were held and minutes recorded.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty. At the last assessment in November 2025, we found that the leaders did not lead the service credibly because of the backdating of and bulk additions of clinical tasks such as medication reviews to patients’ records. At this assessment in July 2026, we found the previous concerns had been addressed and the risks mitigated. The leaders took responsibility for their actions and ensured there was no recurrence.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The service had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They act on the best information about risk, performance and outcomes, and share this securely with others when appropriate. At the last assessment in November 2025, that there was no appropriate oversight of prescription stationery. At this assessment in July 2026, the practice had addressed the concerns and improved the process for prescription stationery security. In addition, the practice ensured that patients were given information about their health condition at the right time and recorded the steps taken in the patient records as they occurred. Policies were updated and others created to ensure an improved service delivery. This showed that the leadership of the practice had taken time to learn from the warning notice issued and mitigated the risks raised by the concerns found at the last assessment.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

The service focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contribute to safe, effective practice and research. The practice had a quality improvement plan in place to help drive improvements in servicesThis focussed on ensuring compliance with the warning notice issued for the breach of regulation related to good governance and completion of the action plan related to the breach of regulation in relation to safe care and treatment. The practice ensured that at this assessment, we saw how much improvement had been made to delivery of safe primary care including participation in ongoing research programs to improve the health of specific patient population such as the African and Caribbean population which would be extended to others in the future.