Marine Medical Group

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-centred care; supported learning and innovation; and promoted an open, fair culture

At our last assessment, we rated this key question as Good. At this assessment, the rating remains the same.

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.

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.

Leaders understood the challenges and needs of people and their communities and worked well with partner agencies to support people effectively. The practice was aware of the potential increase in the local population and was working with partner agencies to address future challenges. The practice had a business plan outlining its development aims through to 2028, including identified areas for improvement. Key priorities included securing additional clinical rooms within the Health Centre to support the growing patient list and meet staff training needs. The plan also highlighted intentions to explore the use of AI technologies to reduce administrative workload and to enhance patient access.

The practice core values of treating patients with dignity and without prejudice, encouraging patient accountability for their own health, and maintaining an ethos of openness and integrity were evident throughout the assessment. These values were consistently reflected in the behaviours and attitudes of the staff we observed.

Although staff fed back to us that they felt that they were consulted by the management at the practice, many of those completing a questionnaire said they did not feel involved in shaping the organisation’s vision or strategy. Leaders had a business plan which included the vision and values, and we saw this was kept under review.

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 and modelled the values of the practice. It was evident that patients were at the heart of everything the practice did, and leaders demonstrated the importance of staff wellbeing to support them in maintaining good outcomes for patients.

Staff told us that leaders within the practice were visible, approachable, and quick to respond to any concerns. They shared several examples of improvements that had been implemented as a result of staff feedback. The practice held a regular “good ideas” meeting, which staff were encouraged to attend. Agenda items were submitted anonymously through an online form, and the meeting provided an open forum for all staff to discuss suggestions for improvement.

We saw the leadership team worked with the other practice in the primary care network and were engaged in the development of primary care services within the local area.

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

The practice had established Freedom to Speak up arrangements with routes available both internally and externally for staff. Staff were aware of how to raise concerns, and we saw examples where staff had used the arrangements in place to positive effect.

The practice had an open culture where staff felt confident to speak up about any concerns. Staff reported that their views were heard and that they felt safe raising issues without fear of negative repercussions. Leaders encouraged honesty and transparency, creating an environment where staff were comfortable sharing concerns.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Policies and procedures to promote diversity and equality were in place. The service also had a designated Equality and Diversity lead who had received additional specialist training in workplace inclusion. Staff had completed training in equality, diversity, and inclusion and understood how to support individuals with protected characteristics, including age, gender, religion, and disability. We saw and heard of no concerns with regards to workforce equality at any level including the recruitment of staff. Adjustments had been made to ensure all staff were valued, for example adjustments to accommodate flexible working where appropriate, were in place.

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 acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Leaders and managers supported staff, and all staff we spoke with were clear on their individual roles and responsibilities. Managers met with staff regularly to complete appraisals and performance reviews. The provider had established governance processes that were appropriate for their service together with named leads in place for key areas.

Staff could access all required policies and procedures and understood the importance of patient confidentiality and information security. There were arrangements for identifying, managing, and mitigating risks and a major incident plan was in place. The provider had established governance processes that were appropriate for the service. Managers held regular practice meetings with staff, during which they discussed clinical concerns and emerging risks. Managers clearly recorded any actions arising from these meetings and ensured they shared these with staff.

During the assessment we identified some systems to support the safe management of medicines could be improved. Leaders implemented changes immediately following our visit to resolve the issues found and put new systems and protocols in place to prevent these in future.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They shared information and learning with partners and collaborate for improvement.

The practice was part of the local GP Alliance Additional Roles Reimbursement Scheme (ARRS) providing additional speciality to the service such as pharmacy, social prescribing, mental health and paramedics.

The provider worked with the other practice within their primary care network to offer extended access. Staff worked closely with community healthcare services, with staff taking part in regular multidisciplinary meetings to support coordinated and integrated care.

The practice holds a Veteran Friendly accreditation. This is a recognised program run by the Royal College of General Practitioners (RCGP) and NHS England for providing better care for veterans.

The practice had an active Patient Participation Group that met in person at least 4 times a year. Meetings were also attended by the practice manager, a GP, and both social prescribers, who contributed additional feedback from the local community.

The service demonstrated a strong 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 service was a training practice for post graduate doctors entering general practice as well as a teaching practice for medical students.

All staff regularly listened to feedback from patients and the community, using it to shape and assess new ways of working. Patient feedback was generated on a monthly basis from the Friends and Family Test, and we saw the majority of feedback was positive. Negative feedback was investigated, and we saw evidence of learning.

The practice had a business plan in place through to 2028 that outlined its approach to driving improvements and embedding good practice to enhance patient care. Leaders encouraged staff to put forward and test out new ways of working, and staff were proactive in contributing ideas. We saw evidence of a broad range of audits and quality improvement initiatives focused on strengthening performance, outcomes, and patient experience. These included clinical audits, pharmacy reviews, benchmarking prescribing patterns against national data, implementing a cloud‑based telephony system, ongoing improvement of the reception signposting and triage tool, making enhancements to the clinical system—including triggers and coding—and improving the identification, recording, and sharing of reasonable adjustments to support equitable access to care.

The practice participated in the Health Literacy Organisational Change Project. The project is a systematic, and strategic approach to transforming a healthcare entity into a "health literate organisation." This means altering organisational structures, policies, and culture to make it easier for people to find, understand, and use information to manage their health. This was a deep end funded project. (Deep End funding in healthcare supports primary care practices in the most socio-economically deprived areas to tackle health inequalities.)

Leaders were focused on further enhancing clinical and administrative efficiency through the use of newly implemented AI‑supported workflow tools. The practice reported that these tools improved documentation, reduced duplication, and streamlined processes, which in turn supported staff wellbeing. Following ongoing monitoring, auditing, and refinement of these systems, leaders were considering expanding the use of formal AI‑related incident reporting and learning processes.

The practice is involved in a pilot project focused on managing frailty at a neighbourhood level through the Northumberland Collaborative, with input from the local trust, council, district nursing teams, and primary care. The pilot is exploring how to delay the onset of frailty across the population, using support from primary care, social prescribers, and Northumberland Council. It is also looking at how to prevent crises and reduce avoidable hospital admissions.

At practice level, work is underway to identify frail patients using the most appropriate assessment tools and to highlight those most in need. District nurses are carrying out comprehensive geriatric assessments and referring patients to a frailty multi-disciplinary meeting so the right professionals can meet their needs. A key part of the pilot is determining what an effective frailty MDT should include. The overall aim is to shift from reactive to proactive care for people living with frailty.