Marden Medical Practice

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 comprehensive inspection in October 2014 we rated this key question as outstanding. At the focused inspection in October 2019 we assessed this key question and continued to rate this question as outstanding. At this comprehensive assessment, the rating has changed to good. We found that some of those elements previously regarded as outstanding practice were now embedded throughout the majority of GP practices. Whilst the provider had maintained this good practice, the threshold to achieve an outstanding rating overall had not been reached.

This service scored 86 (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 had a shared vision, strategy and culture and as a team had developed a mission statement, which was displayed in the practice. This was “To strive to provide high quality clinical care by offering a range of service delivered by a team of dedicated staff in a safe, dynamic and supportive environment. The patient is at the heart of all that we do, and we respond to their individual needs with respect, care and compassion”.Leaders told us the leadership team actively promoted these core principles, ensuring they remained central to their daily work and service delivery, fostering a shared commitment to high-quality, patient-centred care.

Since the last inspection the practice had experienced a significant increase in their registered patients, from approximately 8,500 in 2019 to 11,080 in 2025. This had been driven by local housing developments coupled with providing a service to people in 5 care homes, which had had generated high workloads. Challenges faced included the physical constraint limits of the current building and the ability to expand clinical services or recruit additional staff, despite growing patient demand. Leaders told us as a result, of this they were focusing on maximising the skills of the existing team, using multi-disciplinary roles and digital tools to maintain high-quality care within their current capacity. A 3-year business plan had been developed that outlined how the practice would sustain safe, high-quality care, improve efficiency, and advocate for long-term infrastructure investment, while ensuring staff wellbeing and financial resilience. The practice continued to work with partner agencies to address future challenges.

The practice 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.

Staff told us leaders in the practice were very approachable and responded to any concerns raised and modelled the values of the practice. They spoke highly of the practice leadership team and of the support they provided.

We saw the leadership team worked with other practices in their 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 other practices in the primary care network. Staff were aware of how to raise concerns both internally and externally. They had access to a policy which encouraged staff to speak up as the practice would not tolerate anyone being prevented or deterred from speaking up or being mistreated because they had spoken up.

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

Policies and procedures to promote diversity and equality were in place. We saw leaders had addressed concerns related to discrimination. Adjustments had been made to ensure all staff were valued. Leaders told us the practice was committed to promoting equality, diversity, and inclusion across all areas of employment and service delivery. This was done by ensuring fair and equitable treatment of staff through clear recruitment processes, equal opportunities policies, and a supportive, open-door management culture.

Staff well-being was supported through mental health champions, wellness boards, and flexible working arrangements to accommodate individual needs, including carers and those with disabilities.

The practice had clear responsibilities, roles, systems of accountability and effective governance. They used these to manage and deliver high-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 an effective governance processes that were appropriate for their service. Staff were able to access all required policies and procedures.

Daily briefings and a range of meetings were held with staff, during which they discussed clinical concerns and emerging risks. These helped identify pressure points and reallocate tasks where needed to support one another. Actions arising from these meetings were clearly recorded and shared with staff. Staff took patient confidentiality and information security seriously.

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

The practice was part of the Shrewsbury Primary Care Network (PCN), which consisted of 11 practices covering over 104,000 patients. They delivered enhanced services, shared workforce for example, social prescribers, clinical pharmacists, physiotherapists, and mental health practitioners (MHP), and aligned with the NHS vision of integrated care. These staff worked alongside the core team to enhance patient care and provided patients with access to specialist support closer to home.

The practice also worked in partnership with other services including community health, hospitals, social care, public health, charities, education, and local system governance. They told us this multi-agency collaboration helped them deliver holistic, person-centred care while managing demand on the wider NHS.

The practice had an established and Patient Participation Group (PPG) consisting of 13 members. We spoke with a representative who told us the PPG were proactive and had developed a good working relationship with the practice. Meetings were held once a month with guest speakers attending once a quarter. The PPG were encouraged to share any feedback and offer suggestions to improve patient experience. The PPG supported key initiatives such as bereavement support and community awareness events and during meetings held, they were provided with updates about the practice, for example changes to staffing, partnerships, appointments and training. Future guest visitors included a therapy dog and his handler and a senior member of the local hospital to talk about the new build and planned improvements at the hospital. The PPG had continued to raise funds for new equipment for the practice to improve patient experience.

The service 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. Staff were encouraged to put forward and test out new ways of working. The practice was a training practice for Foundation Doctors and GP Registrars.

A quality improvement project (QIP) was carried out as part of improving patient access and care. With consent, patients administered injections by a nurse to help treat deficiency anaemia were switched to an oral medicine following a protocol. A re-audit showed a saving of approximately 568 nurse appointments annually. Additional QIPs focused on transitioning from child to adult services and clinical staff supervision. In addition the practice had piloted the Period Poverty Project, supporting vulnerable groups in accessing healthcare.

The practice learning disability champion had developed a new system of sending information from the practice in red envelopes to help these patients identify health information received from the practice. The practice collaborated with the local Integrated Care Board (ICB) to develop best practice guidelines and participated in local learning disability network meetings.

Since the last inspection, the practice had been actively involved in the Cavell Centre programme, aiming to bring together 6 local GP practices to establish a modern health and wellbeing hub in Shrewsbury. Despite extensive planning and public engagement, government funding was withdrawn, and the project halted.