The Willow Tree Surgery

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked for evidence that staff involved people in decisions about their care and treatment and provided them advice and support. Staff worked with other services to provide people’s health needs. At our last assessment using the old methodology in 2019, we rated this key question as good. At this assessment, the rating has changed to requires improvement because we found issues with how the provider assessed the needs of the patients and the systems put in place to ensure the needs were identified timely and risks mitigated.

This service scored 50 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. Audits of long-term conditions were not always completed. Care plans were not always completed and reviewed regularly. We found a patient with a do not attempt cardiopulmonary resuscitation (DNACPR) record completed in June 2024, patient was seen regularly to review needs. However, care plans were not reviewed regularly. Feedback from people using the service was negative. People did not feel involved in the assessment of their needs as they felt front desk staff should not be assessing what they need as this should be done by the clinical staff. Health checks reviews were not fully completed for those who were eligible for them.

The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Patient clinical records we viewed did not show care was provided in line with current evidence-based practice and guidance. There were patients who did not have medication reviews since September 2023 and some of them did not know about the side effects of the medications such as Topiramate and any preventative measures needed to be taken to safeguard their health and wellbeing. Text messages with a link to patient information leaflet only were sent to the patient on the side effects of some of these medications, no documentation in patient notes about discussion had with patients about it.

The practice worked with the primary care network and other practices within the Hillingdon Confederation to deliver people’s care, treatment and support. The practice worked with other services or health care partners to ensure continuity of care.

The practice liaised with the social prescriber who was a member of the ARRS workforce within the practice who signposted patients to other services within the community that were beneficial to their health and wellbeing. Other healthcare professionals such as mental health team and district nurses worked with the practice to support the patients to live healthier lives. The practice website had information to help the patient population live healthier lives, however, due to the deprivation in the area, how effective this may be was unknown.

The service routinely invited patients for cervical screening and child immunisations but the uptake remained below the national averages. The practice explained that the uptake had remained low because the level of deprivation in the area which was in the 4th lower decile might have possibly impacted on the results. The principal GP informed the assessment team that door knocking occurred to improve the level of uptake, but the impact of this measure was yet to be seen. Patients’ feedback made available to us by the local Healthwatch showed the Healthwatch survey indicated the borough’s patients were more concerned about their immediate health care needs and not what might possibly affect their health in the future.The practice did not share any action plan to make the patient population understand the need for these screenings and immunisations and how it could impact their health and future.

The practice told people about their rights around consent and these rights were respected. Only 3 out of 8 staff file records we checked showed completion of Mental Capacity Act 2005 training. The practice completed Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions in line with relevant legislation.