Nuffield Health Shrewsbury Hospital

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 there was an inclusive and positive culture of continuous learning and improvement that was based on meeting the needs of patient who used services and wider communities.  We checked that leaders proactively supported staff and collaborated with partners to deliver care that was safe, integrated, person-centred and sustainable, and to reduce inequalities.

At our last assessment we rated this key question as good. At this assessment the rating has remained good. This meant patient’s needs were met through good organisation and delivery.

We have not awarded this service a score for Well-led.

Find out about when we will not publish a key question score and what we look at when we assess Well-led.

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 patient and their communities.

The service had a vision and objectives for what it wanted to achieve and turn it into action. This vision reflected the overarching provider aims and objectives. The hospitals strategy on a page included a vision and purposes, strategic focus, how the success would be measured and what they would do to achieve it. Staff spoken with had awareness of how their work contributed to achieving targets. Staff felt motivated about the future and planned changes for the service.

Nuffield Health is a charity, and managers and staff were proud it was a not for profit organisation with any “profit “put back into patient care and community initiatives. They also maintained regular engagement with the Integrated Care Board to ensure services were aligned with local health priorities and population needs. 

The service promoted equality and diversity in daily work and provided opportunities for career development. The service had an open culture where patients, their families, and carers as well as staff could raise concerns without fear. 

Staff felt respected, supported, and valued. Staff reported that the leadership culture was inclusive, and they felt valued and respected. Relationships between staff of all grades were positive, with strong teamwork and collaboration.

Team and individual staff achievement and success were recognised and celebrated. 

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 always did so with integrity, openness and honesty and understood the impact their behaviours and leadership had on patient outcomes and experience. 

Nuffield Health Shrewsbury had a Hospital Director who had overall responsibility for the management of the hospital and was the registered manager. The senior leadership team included the Director of Clinical Services who directly managed all clinical heads of department which included the Head of Theatres and the surgical Ward Manager.  Leaders had considerable experience in healthcare both within the NHS and private health care and had a range of experience, skills and abilities to run the service. Leaders understood and managed the priorities and issues the service faced. Leaders were visible and approachable in the service for patients and staff.

Staff felt the leaders supported them to develop their skills and take on more senior roles.  Staff told us leaders were approachable and accessible.

Staff without exception provided positive feedback about their leaders. They spoke of how their immediate manager was approachable and supportive and made them feel involved and promoted a no blame culture. Staff spoke extremely positively of the hospital director describing them as very visible, inspiring, and motivating and the positive impact they had on staff morale and developments in patient care; Staff said they felt supported respected and valued and were proud to work for the service. 

There was strong collaboration, team-working and support and a common focus on improving the quality and sustainability of care and patients’ experiences. The culture of the service centred on the needs and experience of the patients. Staff were passionate about delivering high-quality care and treatment for patients requiring it as well as their loved ones.

The staff survey also confirmed staffs appreciative of supportive managers and colleagues. Staff described their managers as brilliant, faultless, approachable and highly supportive contributing to a positive working environment. 

Leaders took incidents seriously and knew how to deal with concerns when raised which promoted a positive culture in the service. The hospital director and other senior managers attended all departments at least daily to both assess for themselves how the service was running and provide support to staff id needed.

In addition to mandatory, statutory and role-specific training requirements, senior leaders demonstrated a strong commitment to workforce development, leadership capability, quality improvement and professional excellence through additional training, education and opportunities available.

Staff and patient survey results were acted upon. For example, following the staff survey plans in were in place for various projects hospital wide including improvement of patient rooms and nurses’ station. Common concerns identified within the staff survey were ageing equipment and excessive heat in warmer months due to a lack of air conditioning. Senior leaders had replaced aged equipment, and this was ongoing with the new beds rollout. Following patient feedback there was improved communication throughout the patient journey ensuring patients felt informed, supported, and involved in decisions about their care. Actions undertaken included follow up calls to all new patients after their initial appointments to confirm next steps, answer questions and provide reassurance.

The service fostered a generally positive culture where patients felt they could speak up and their voice would be heard.

Staff and leaders acted with openness, honesty and transparency. Staff were encouraged raise concerns and offer ideas; the culture allowed staff to be confident their voices were heard. 

Staff told us when they had raised valid concerns or if they needed to they would be supported, without fear of detriment. When concerns were raised, leaders investigated sensitively and confidentially.  

Patients, their families and carers were provided with information to explain how they could raise a concern and how this would be investigated. Staff told us how they would respond to immediate concerns or complaints with a view to resolution. There were policies to support the complaints process.  

Staff knew about the Freedom to Speak Up (FTSU) Guardian and could name who they were. We spoke with FTSU Guardian during the inspection. They told us how they did not have any major themes or trends and were going to commence monthly walk arounds and went to the daily huddle to increase their visibility and awareness with staff. There was no specific report completed by the Guardian; they fed back monthly to the senior management team. If staff felt unable to speak up via the usual routes they could raise the concern via a telephone number, they were provided with. 

The hospital actively promoted the FTSU process to ensure staff felt confident and supported in raising concerns. In October 2025, the hospital held a "Wear It Green" awareness day in support of FTSU, which was promoted across the site to increase visibility of the service amongst staff, consultants, and visitors. The event provided an opportunity to raise awareness of speaking up processes and the support available through the FTSU Guardian and FTSU Champions. 

In addition, an annual FTSU engagement calendar had been developed, with activities scheduled throughout the year to continually promote the FTSU agenda. These activities were led and supported by the hospital's network of FTSU Champions, who played a key role in raising awareness, encouraging open conversations, signposting staff to appropriate support, and fostering a positive speaking-up culture across the organisation. 

The effectiveness of these initiatives was reviewed through regular engagement with staff, FTSU Champion feedback, and ongoing monitoring of speaking-up activity to ensure awareness and accessibility of the FTSU process remained high. 

The service valued diversity in their workforce. Staff work towards an inclusive and fair culture by improving equality and equity for everyone.

Leaders acted to improve where there were any disparities in the experience of staff with protected equality characteristics. 

Leaders took steps to remove bias from practices to ensure equality of opportunity and experience for the workforce within their place of work, and throughout their employment. Staff told us they had opportunities to apply for project work, new roles and to undertake external studies through an open application process. Staff told us how they completed a diversity module as part on their training. Staff with disabilities were offered reasonable adjustments to support them to carry out their roles well. For example, we heard how a staff member had been supported well to return to the workplace after a period of absence and how they continued to be well supported.  

The service acted to prevent and address bullying and harassment at all levels and for all staff, with a clear focus on those with protected characteristics under the Equality Act and those from excluded and marginalised groups. Staff felt everyone was treated fairly and that they would be able to report behaviour or attitudes which were negative in style. 

All staff had completed training in relation to bullying and harassment. Leaders monitored the diversity of the workforce. Nuffield Health as a whole had several colleague networks including a Muslim network, Pride network, a social mobility working group, a neurodiversity network as well as a women's network that staff could get involved with if they wished.

The service had clear responsibilities, roles, systems of accountability and good governance. Staff used these to manage and deliver good quality, sustainable care, treatment and support. Staff act on information about risk, performance and outcomes, and 

There was a clear governance structure, this included a quality and safety committee, a medical advisory committee, various forums including a water forum, health and safety forum, a patient focus forum as well as a hospital adverse incident forum.  There was a range of information collected, monitored and communicated internally at the relevant committee meetings and was fed upwards to the provider. Performance data was analysed and compared within the provider organisation and where improvements were needed at the location level, action plans were developed to make this happen. 

Nuffield Health had set out 5 ambitions. These were to provide the best care and support you can get anywhere, to deliver the best possible customer and patient experience, to be the best place to work in health and wellbeing in the UK, to be at least as efficient and productive as their competitors and to multiply their social impact and sustainability.  

Staff at all levels were clear about their roles and accountabilities. Staff had job descriptions, and these set out expectations and responsibilities. Where senior staff had designated tasks related to audit and monitoring quality of services, they understood what was required of them.

We reviewed several service level and provider policies and found these were up to date and readily available to staff. There was leadership oversight of the accuracy and validity of each policy. 

There was a medical advisory committee (MAC) led by a chair and supported by the service leadership, which included approval of practicing privileges and review of clinical outcomes of individual doctors. If there were any concerns with performance, there were processes to follow and if necessary, information would be shared with professional bodies as required. We reviewed the MAC minutes from August 2026 and saw topics of discussion included Never Events across sites, companywide deaths, documentation, and the hospital risk register.  

We reviewed the senior leaders board meeting minutes and found they discussed key areas of governance including incidents, actions, risk registers, internal assurance, and quality strategy priorities.  

There was a hospitals medicines management and medical gases meeting. We reviewed the notes from July 2026 and found areas discussed included medicines management updates, regulatory compliance internal quality assurance review in addition to reviews of themes, trends and lessons learnt. 

Infection prevention policy compliance and new policies were discussed within the hospital infection prevention team. The hospital had a deputy director of infection control, within these meetings staff also discussed any outstanding actions, infection surveillance, contamination, audits and mandatory training.  

We reviewed the notes from the clinical heads of department meetings dated July 2026. Topics included an action log, safeguarding, mandatory training, complaints, clinical audits, duty of candour, performance development reviews, and general data protection regulation.  

We reviewed the quarterly hospital quality report from April to June 2026. The report had information on incidents, safeguarding, medicines management, infection prevention, audit results, complaints, patient experience, the site quality scorecard which scored an overall 100% in addition to complaints. The hospitals site quality score card was 100%, this included safety, effectiveness and experience at the hospital which all scored 100%.  

The hospital had a weekly hospital Shrewsbury flash Urgent information to share with staff). We reviewed the flash from 17 August 2026 which included a policy of the week, what is our knowledge gap, patient satisfaction scores on social media.  

Leaders made sure that accurate information was discussed and shared with key staff. For example, team meeting topics included key areas of governance such as lessons learnt from incidents, the risk register, infection prevention, and complaints. 

Staff could find the data they needed, in easily accessible formats, to understand performance, make decisions and improvements. The information systems were integrated and secure. Data or notifications were consistently submitted to external organisations as required. 

Leaders were aware of the risks in their department such as ageing equipment in ophthalmology. Risks were clearly identified and a formal log of these was used to keep oversight and manage mitigations and/or bring to resolution. Staff contributed to decision-making to help improve sustainability and improve quality of care. Risks were mainly around the facilities such as the lack of air conditioning and aged equipment we saw this was being addressed.

Audit processes and the outcomes were used to ensure quality of services was maximised. Where improvements were required, leaders ensured action plans and the monitoring of these led to positive changes.  

Senior leaders had undertaken several themed reviews of clinical incidents which included veinous thrombosis embolism (VTE) management which had resulted in participation in National NHSE VTE Audit;  and an updated VTE Prevention and Treatment Protocol; Unplanned transfers to another provider this review had led to the Introduction of the Deteriorating Patient Policy and Manual and clarification of actions in relation to early warning scores and tool requirements for the onward communication.

The hospital had achieved the National Joint Registry Quality Data Provider Award gold in 2025 for its commitment to patient safety through the registry.  

The service had plans to cope with unexpected events and had a business continuity plan. Emergency plans were reviewed regularly. In addition to the daily multidisciplinary huddle which identified any operational risks, capacity issues, staffing concerns a further operational call took place daily to review the day's activity, address any emerging concerns and ensure plans were in place for overnight operations and the start of the following day. Each week the key stakeholders on call for the hospital were shared with everyone on site.  

There was an information governance policy. The hospitals practicing privileges policy detailed data protection within including how it was the responsibility of medical practitioners who were granted practicing privileges to manage data in accordance with legislation including data protection legislation. We observed that computers were secure as they were password protected. 

We saw staff proactively reported information governance incidents and there had been 15 information governance incidents over the last 12 months. As a result of the incidents actions were taken including retraining and reminders for staff, reissuing and reinforcing the clear desk policy, and discussions with staff. Leaders told us how they had seen a reduction in the number of information governance incidents. Information governance incidents were reviewed in quarterly information governance meetings and quality and safety meetings. Policies and processes were in place for when breeches occurred and each case was assigned a level of harm.  

Nuffield Health had a sustainability plan and targets for all its services. Actions were in place to ensure 100% of electricity was from natural renewable sources, moving away from single use items when possible and review of clinical pathways and disposal of clinical waste and using less carbon intensive gases Staff we spoke to said key staff had taken on the role of encouraging effective recycling and waste disposal with random checks of waste bins to ensure the correct items were in the correct bin and highlighting when improvements were required.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for patient. Staff share information and learning with partners and collaborate for improvement.

Staff and leaders at the service collaborated with relevant external stakeholders and agencies to improve care and treatment for patients using the service. For example, the hospital supported the community through its NHS contacts. The hospital had also attended a listening group open to local constituents discussing Fit for the future. Through discussion with their consultants, they were also better able to identify where they may be able to support in the NHS. For example, they had recently launched a heart health clinic following recommendations from their cardiologists.  

We saw the hospital engaged with private health insurance companies, local NHS trusts and other private hospitals to share information.

They held regular meetings with the local ICB to review performance, quality assurance and the ongoing contracts.

We saw service level agreement for transfer of patients to local NHS trusts and intensive care units when required.

Managers had identified a need for outreach clinics to reduce travel time for rural communities. Managers were also working to ensure improved and more timely access to healthcare for Welsh patients.

Some senior leaders were part of regional networks to understand the needs of the community and the provider ambitions. Leaders and staff actively and openly engaged with patients, staff, equality groups, the public and local organisations to plan and manage services. 

The service had a strong focus on continuous learning, innovation and improvement across the organisation and local system. Staff often encouraged creative ways of delivering equality of experience, outcome and quality of life for patient. Staff actively contributed to safe, effective practice and research.

Staff were committed to continually learning and improving services. There were processes for learning when things went wrong and sharing practice excellence, both locally and nationally.  

Staff were proud of the orthopaedic enhanced recovery programme, with the majority of hip and knee replacement patients discharged either on the same day or following a one-night stay after their surgery. Working in partnership with the physiotherapy team a comprehensive prehabilitation programme had been developed with targeted assessment, education and physical preparation. This approach improved confidence, supported pain management, set clear expectations regarding recovery and length of stay and ensured that both patients and their families were fully prepared for discharge and ongoing care at home. 

The ward team followed up all orthopaedic patients by telephone within 24-hours of discharge using the Nuffield Health post-operative follow-up framework. 

The National Joint Registry outcomes demonstrated excellent clinical results and supported the effectiveness of the enhanced recovery pathways. 

Staff and leaders were committed to excellence that centred on the patient experience. Where they saw a need, they worked together to find a solution. Delivering preventative healthcare was a key priority and aligned closely with Nuffield Health's ambition of building a healthier nation. In collaboration with consultant cardiologists, a comprehensive cardiac assessment pathway had been developed designed to support patients experiencing cardiac symptoms or concerns. Recognising the increasing demand for cardiology services and the challenges associated with lengthy waiting times, a streamlined package of specialist review and diagnostic investigations had been developed, including advanced imaging such as Cardiac MRI and CT scanning. This provided patients within the region with accessible, high-quality care closer to home and offered an affordable alternative to travelling to larger centres. 

The commitment to long-term health management extended beyond diagnosis and treatment. Eligible cardiac patients were able to access free Long-Term Conditions Programme, prescribed through their cardiologist, providing a comprehensive and integrated pathway of support focused on improving health outcomes and quality of life. 

Nuffield Health's Artificial intelligence -enabled tools have provided valuable insights into clinic utilisation, capacity management, referral trends and payor activity. These capabilities support informed decision-making, maximise access for patients and enable strategic planning for future growth opportunities, including the expansion of services to new and developing markets such as Wales. 

Endoscopic Spinal Surgery will commence from October 2026. This was an innovative, minimally invasive technique representing a significant advancement in spinal care, offering suitable patients with lumbar degenerative conditions access to day-case surgery, reduced recovery times and earlier return to normal activities. The service will provide an important new treatment option for patients facing prolonged waits for specialist spinal intervention. 

Staff were supported to have the time to develop their skills around improvement and innovation and to pursue areas of interest in the service. Staff were offered the opportunity to attend lunch and learn sessions. The hospital had arranged a session with a consultant to deliver an educational presentation on a topic of choice. Topics could be tailored to interests including areas such as orthopaedics, women's health, cardiology. The sessions were designed to be informative and interactive. We also saw clinicians had been invited to a learning session with a focus on helping clinicians access imaging more quickly and confidently for their patents.  

The hospital had achieved gold accreditation for Aseptic Non-Touch Technique valid from December 2025 to December 2028 and the National Joint Registry award for Quality Data Provider 2025.