Evergreen Practice

On this page

• 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

Our assessment found: • The practice provided patients with timely access to care and treatment and used data and audits to monitor performance and prevent avoidable delays in access. • The practice prioritised vulnerable patients for same day access to care and treatment. • Reasonable adjustments were made to ensure equity in access. • The practice considered the needs of all patients and took action to reduce the likelihood of patients facing communication barriers such as digital exclusion. • The practice planned and delivered services to meet the needs of its patients and maximised the opportunities provided by digital technology.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Person-centred Care during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We asked the provider to place a link on their website to our Give Feedback on Care process so we could hear of patients’ experiences of care. During the assessment we received 24 pieces of feedback of which 22 were positive and 2 were negative. Of the positive feedback we found 5 submissions commented specifically that the patients had been able to access care and treatment in a timely manner. 12 pieces of feedback showed patients’ experiences of care had been positive and 5 pieces of feedback commented specifically about individual clinicians. The 2 pieces of negative feedback were about individual experiences that did not identify any trends or themes. We reviewed the results of the GP Patient Survey (GPPS) and found the practice was performing at and in many cases, above, the national averages in terms of patients’ experience when accessing care and treatment at the practice. During the assessment we spoke with a member of the Patient Participation Group (PPG). The discussion focused mainly on their role in the PPG but also covered their experience as a patient. They reported that in their experience, telephone access was good, the repeat prescription process had worked effectively and, staff were friendly, caring and helpful. They reported this made accessing services easier and pleasant.

The practice had a clear focus to provide timely access to care and treatment. We saw evidence of this in processes and outcomes but also through discussions with staff. Leaders and managers explained they felt patients had good access to an experienced clinical team. Because of this, the practice felt patients were triaged to the correct pathway from the point of contact, which prevented the need for repeat consultations about the same condition. Other reasons given included a small practice boundary area and the practice did not support a care home. This was supported by a review of appointments which indicated there were a variety of option available in a timely manner. The practice explained they continually monitored the growth of the practice unverified as an 18% increase over 4 years, and the demand caused by this. Steps they had taken or considered to be able to continue to provide good access included temporarily closing registrations to new patients and consideration of a merger, which had not happened.

Patients could request appointments online, in person or via telephone. Once the request was made, it would be triaged and allocated to the most appropriate clinician, the patient was then contacted by their preferred communication method and offered an appointment. The practice had systems and processes to prioritise vulnerable patients. For example, the supported a women’s refuge in the local area and explained these patients were always given same day access to care. We also found 3 appointments were embargoed at the end of the day to ensure any vulnerable patients, or those with urgent needs, would be able to receive same day access to care. These appointments were released once the practice was confident they would not be required that day. The GP patient survey included positive outcomes related to access and we found the practice audited its own processes to ensure patients continued to be able to access care and treatment in a timely manner. We saw an example which was completed because the practice was co-located with other healthcare services and wanted to know how much time its reception staff spent on activities unrelated to the practice, such as directing patients around the building or answering queries from patients on behalf of other services. The audit also included time spent checking patients in to appointments at the practice. The first cycle of the audit was completed in August 2023 and 3.5 hours were spent checking in patients and 4.5 hours on activity unrelated to the practice. The practice re-introduced the self-check-in machine and changed signage at their reception which reduced check-in time by reception staff to 2 hours and time spent on unrelated activity to 3 hours. This gave reception staff more capacity to support Evergreen Practice patients to receive good access to care and treatment.

We asked the provider to place a link on their website to our Give Feedback on Care process so we could hear of patients’ experiences of care. During the assessment period we received 24 pieces of feedback but none related to the quality statement. However, in the 12 months preceding the assessment we received 2 pieces of feedback related to patients’ experience of using interpretation services within the practice. Feedback highlighted a concern that due to the responsiveness of the interpretation service patients with communication needs did not have the same access to care as a patient without a communication need, particularly for urgent care

An external interpretation service provided translation and interpretation services. Managers explained, while they were aware of the risk of delays, when it was an urgent matter and the translation service was not responsive, they would allow a family member, carer, or friend to interpret for a patient to ensure access to care and treatment was not delayed. We heard of an example of how the practice had supported a family from Afghanistan. Instead of requiring the family to book multiple appointments to meet the needs of each member of the family, they offered an extended appointment, where the whole family could attend and the lead GP could address all their needs at that time.

The practice explained that they had offered a self-book method for asthma clinics and 4 clinics had been completely booked via this method. However, the practice had trialled self-book for other areas, for example clinics for chronic obstructive pulmonary disease (COPD), and had found the take up had not been as positive. The practice had considered potential reasons for this and wondered whether different conditions were more likely to affect different patient groups more and whether there was a link between this and confidence with digital booking methods. In response, the practice had decided not to use this booking method for the COPD clinics again to ensure no potential barriers to care were created by over-using technology.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.