Marden Medical 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

We looked for evidence that the service met people’s needs, and that staff treated people equally and without discrimination.

At our comprehensive inspection in October 2014 we rated this key question as good. Because of the assurance received from our review of information and our methodology at the time this rating was brought forward at the focused inspection carried out in October 2019. At this comprehensive assessment, the rating remains the same.

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 practice made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. Our review of clinical records and staff discussions showed patients were supported to understand their condition and were involved in planning for their care needs. They were also involved in decisions about their care.

Reasonable adjustments were offered including to people with a learning disability or autism. These included appointments scheduled with familiar clinicians at quieter times to reduce sensory overload or extended, easy-read appointment letters and health check templates, visual aids or the involvement of carers and support workers to ensure patients had the time they needed to understand and engage with their care. The practice had a dedicated learning disabilities champion, who was soon to be taking on the role of autism champion, acting as a direct and consistent point of contact for patients and their families.

The practice understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. We saw the practice worked in partnership with other services and tailored its services to meet the diverse needs of its community. There were established mechanisms for engaging with the community healthcare provider and local care home providers. To ensure continuity of care, support, and treatment there were established systems to meet the needs of all patients, including vulnerable patients and those with complex health conditions. Weekly face-to-face ward rounds were carried across 5 local care homes that the practice provided a service to, ensuring consistent and proactive clinical care, while a GP carried out a monthly review to support ongoing medical oversight.

The practice was able to supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. They provided access to interpreter services as well as an on-site electronic interpreting device, which allowed for real-time interpretation during face-to-face consultations. Patients were informed as to how to access their care records.

Leaders told us to help them deliver more personalised, inclusive, and responsive care, they had been actively working with their Primary Care Network (PCN) on the "Making GPs More Accessible" project, aimed at improving access to care for all patients, particularly those with additional needs. As part of this initiative, they invited a group of patients to a dedicated meeting to share their experiences and challenges around reasonable adjustments and accessible information within primary care. The feedback from this session was invaluable and had directly informed the development of a new “About Me” patient passport. The tool allowed patients to share key information about their communication preferences, access needs, and how best to support them during appointments and was produced by Shropshire Autism Hub as part of a pilot project funded by NHS England.

The practice had effective systems in place for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

Complaints we reviewed were managed in line with the practice’s policy. Learning from complaints was evident and staff were able to identify changes made as a result of patient feedback. Patient feedback was gained through a variety of methods to ensure patients experienced positive outcomes. These included the Patient Participation Group (PPG) which offered a structured forum for patients to share ideas and provide input on services provided by the practice, Friends and Family Test (FFT), online reviews, informal feedback during consultations and discussions in addition to practice surveys. Leaders told us that feedback gained was regularly reviewed by the practice team, with themes identified and plans developed where needed, ensuring that patient experiences directly informed service improvements and the delivery of high-quality, patient-centred care.

The practice results from the most recent National GP Patient Survey published in July 2025 showed a decline in patient satisfaction. The practice was performing below average for some indicators relating to access. For example, 50.6% of people responded positively to the overall experience of contacting the GP practice, compared to the national average of 69.6% and 50.2% responded positively to how easy it was to contact their GP practice by phone compared to the national average of 52.9%. Leaders were disappointed with the outcome of the survey and in response had developed an action plan, which included immediate steps, strategic aims and actions by priority areas and 6 month and 12-month targets.

The practice had a triage process to ensure that patients with urgent needs were identified and prioritised promptly. Patients could access the service to suit their needs and request appointments in person, online or by phone. For patients who were digitally excluded, a range of non-digital options, including face-to-face appointments, telephone consultations, and paper-based communications were available. Leaders told us where patients required additional support, staff were able to guide them through processes in a way that met their individual needs ensuring all patients could access services, regardless of language or digital ability.

Appointments were assessed by staff who were trained in care navigation and used an online toolkit and a dedicated emergency triage protocol developed by the clinical team. Leaders told us this enabled safe and efficient signposting or escalation to a clinician when urgent care was required. They considered the system ensured that emergencies were dealt with immediately, while also directing non-urgent cases to the most appropriate service or professional in a timely manner.

Leaders told us the eConsult facility, a form based online consultation and triage platform was already available to patients but capped each day. From 8 September 2025, this was fully opened for the duration of the practice core opening hours. To improve access further and patient satisfaction, leaders advised us from November 2025 they were moving towards implementing a total triage system. The system would move from a walk-in/telephone-first model to a system where all patient requests were triaged by a clinician before an appointment was offered. An action plan had been developed, which included engagement, technology, training, sustainability and continuous improvement in addition to a review of number of case studies.

Reasonable adjustments were made where needed, including offering face-to-face appointments, easy-read materials, interpreter or British Sign Language services, and support with completing forms or using online systems. The practice offered early, late and extended appointments for people with a learning disability or autism. An automatic door had been fitted to the main entrance and treatment rooms were available on the ground floor to provide easier access.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Staff treated people equally and without discrimination. Leaders proactively sought ways to address any barriers to improving people’s experience. Staff understood the importance of providing an inclusive approach to care and made adjustments to support equity in people’s experience and outcomes. The provider had processes to ensure people could register at the practice, including those in vulnerable circumstances such as homeless people and Travellers. The practice was the dedicated Special Allocation Scheme (SAS) for Shropshire, for patients who had been removed from their GP’s list, ensuring they continued to receive primary care services.

The practice had processes in place to ensure there was no discrimination when making care and treatment decisions, with all patients treated fairly and according to clinical need. Staff followed equality and diversity policies, and training was provided to promote awareness of unconscious bias and the importance of inclusive care.

Leaders told us when planning services, they regularly reviewed the local population health data, including information from their Primary Care Network (PCN), public health reports, and practice-level demographics such as age, deprivation levels, ethnicity, and prevalence of long-term conditions. This helped them tailor their services to meet the specific needs of their patient population. They told us their high number of elderly patients and care home residents had shaped their proactive care home visiting model, while local health inequalities had influenced their involvement in initiatives like the Period Poverty Project and Safe Surgery registration.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Leaders told us patients were supported and empowered to take part in decisions about their care. Our records review showed people were supported to consider their wishes for their end-of-life care, including cardiopulmonary resuscitation and this information was shared with other services when necessary.