Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at South East London Doctors’ Cooperative (SELDOC) Ltd Dulwich on 20th and 21st January 2015. Overall the provider is rated as good.

Specifically, we found the provider to be good for providing safe, effective, caring, responsive and well led services.

Our key findings across all the areas we inspected were as follows

• Staff understood and fulfilled their responsibilities to raise concerns and report incidents and near misses. All opportunities for learning from internal and external incidents were maximised.
• The service used innovative and proactive methods to improve patient outcomes, working with other local providers to share best practice. For example they provided medical input to the local at home service to avoid admissions and worked with the ambulance service to reduce admissions to hospital for category C calls.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment. Information was provided to help patients understand the care available to them.
• The service implemented suggestions for improvements and made changes to the way it delivered services as a consequence of feedback from patients
• The service had good facilities and was well equipped to treat patients and meet their needs. Information about how to complain was available and easy to understand

The service had a clear vision which had quality and safety as its top priority. A business plan was in place, was monitored and regularly reviewed and discussed with all staff. High standards were promoted and owned by all staff with evidence of team working across all roles.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

South East Doctors London Emergency Cooperative (SELDOC) is made up of a group of local doctors based at East Dulwich Community Hospital. SELDOC has 600 GP members from over 125 practices.They are responsible for providing emergency primary care out-of-hours general practitioner (GP) cover for the boroughs of Lambeth, Southwark and Lewisham. The service is partly commissioned by the CCG covering nine GP practices and partly commissioned by local GPs who have opted in under their GP contract and have elected to have their out-of-hours emergency cover provided by SELDOC. In 2011 the population was estimated at approximately 900,000 for the three boroughs and all have a predominantly younger population and a higher than average black and ethnic minority population. All three boroughs have high levels of deprivations and range between 13th and 26th out of 365 local authorities; however, the majority of people in the boroughs are registered with GPs.

SELDOC (South East London Doctors Co-operative) was established in April 1996 to provide out-of-hours General Medical Services on behalf of its GP members from a base at Dulwich Hospital, London SE22, covering a patient population of around 900,000 people across three South East London boroughs of Lambeth, Southwark and Lewisham.

During our inspection we spoke with five Patients who were using the out-of-hours emergency GP service, and 15 members of staff. Staff members included the medical director, director of operations, registered manager, pharmacy leads and operational staff such as call handlers.

We found that the service had systems in place to ensure that the provider could effectively respond to the needs of the patient’s accessing the out-of-hours service safely. Information regarding the care received by patients was shared with the patients’ GP in a timely manner to ensure continuity of care between the different service providers.

Patients received a caring service. Patients told us that they were happy with the care they received and that they were involved in the decisions about their care. We were told that staff were polite and respectful and we observed this to be the case. There was opportunity for people to provide feedback as questionnaires were available in the waiting area. There was easy access to the location although the premises were on the site of an old community hospital

The service was responsive to patients’ needs. Staff had access to the appropriate equipment, training and support. The provider carried out the appropriate employment checks on new and temporary staff to ensure that they able and safe to carry out their roles.

Staff told us that they felt supported and that the service was well led. There were regular team meetings to ensure that information was cascaded to all staff team members; this included learning from incidents and changes to practice.

The inspection did not identify that the provider was currently non-compliant with the Health & Social Care Act (2008) regulations.