Case Studies

Corporate Governance

SELDOC strives to continuously evolve and improve their Corporate Governance strategy through the integration of robust business functions with exemplary clinical governance. By monitoring, maintaining and exceeding quality standards in line with National Quality Requirements, the Care Quality Commission, Primary Care Foundation Benchmarking and the NHS Outcomes framework, SELDOC provides complete assurance for the patients they serve and the commissioners and partners they work with.

This is underpinned by the development of the SELDOC Corporate Governance Handbook, setting out each Director’s responsibilities and providing a clear guide for both Board members and staff alike. The handbook references the Companies Act and Institute of Directors as well as specific GP/NHS material such as ‘The healthy NHS Board’ and the Londonwide LMC.

Breadth of Expertise

The diversity of the SELDOC board reflects the breadth of knowledge required to run a service that is able to react proactively to their partner’s needs within a framework that promotes best practice in all areas. Alongside the six GP Directors, the SELDOC Board also benefits from three experienced Executive Directors; the Director of Operations, Medical Director and Finance Director, each with the same level of legal responsibility and all registered as Directors at Companies House.

Furthermore, the appointment of two Non- Executive Directors from the local area reinforces SELDOC’s belief in the importance of bringing a community perspective to Board and Committee meetings. As a result, SELDOC can draw upon a wide range of experience in everything from company law and corporate governance to clinical excellence and community involvement. For commissioners, the advantages are two-fold: access to a one-stop-shop for all unscheduled care related needs, combined with the assurance of proven robust systems and checks.

“We would be delighted to share this expertise with any potential partner, GP Federation or Commissioner looking to develop sound governance procedures. In the past, our Finance Director has given workshops on management and annual accounts and we have engaged a HR consultant to run workshops on Employment Law.”

Dr Emma Rowley- Conwy, Chair of the Board

Your Proactive Partner

An example of SELDOC’s quick reaction to commissioner’s requirements was seen in 2013, when the NHS 111 service went live. NHS Direct was struggling to provide a robust service for the whole sector, and as a result, SELDOC received repeated requests to extend their direct access service.

SELDOC swiftly undertook recruitment and training of call handlers to cope with the increased workload, ultimately extending their call centre capacity to ensure calls were dealt with in a timely and professional manner. SELDOC continues to provide direct access and call handling for patient populations in Lambeth, Southwark and Lewisham.

“SELDOC’s ability to respond to a significant challenge in a short timescale exemplifies our flexibility and operational sophistication, enabling us to cope effectively with unforeseen events.”

Derek Witt, Director of Operations

Quick Thinking

SELDOC’s motto; ‘you are caring for your colleagues’ patients’ was never more evident than in a recent case when a patient presented with difficulties in breathing, leaving them unable to talk to the duty doctor on the phone. Although the patient had previously consulted with their GP and was prescribed amoxicillin, the duty doctor examined the notes and, due to a prior history of polio and scoliosis (resulting in decreased lung capacity) immediately called for an ambulance. This prompt action undoubtedly saved the patient’s life, as witnessed by the heartfelt letter we received from his wife (as shown below):

“I would like to thank the doctor on duty that recognised a real emergency, called an ambulance immediately and showed his concern by calling a few minutes later to check if the ambulance had arrived. Almost seven weeks later my husband remains in Critical Care at Kings College Hospital but is improving every day. I am so grateful to this unknown doctor who helped save my husband’s life.”

Patient’s wife

Always on Call

SELDOC’s community involvement extends beyond simply promoting the service. A SELDOC doctor attended a recent carer’s event in Catford and became concerned when a person complained of excruciating pain in their abdomen. On examination, the doctor discovered there was severe tenderness and referred them directly to A&E at Kings College Hospital. It was found that the patient required urgent surgery for polycystic kidney disease.

“Our doctors are rooted in the communities they serve, and this degree of ‘ownership’ extends far beyond the normal out of hours service. Our cooperative ethos and hands-on approach demonstrates our commitment to provide the very best in patient care.”

Claudette Parchment, Patient Experience and Quality Manager

Medicines Management

SELDOC constantly reviews its medicines management and procedures, ensuring they meet and exceed statutory national standards. Over and above this, SELDOC undertook to implement the Department of Health policy to increase efficiency and capacity by bringing care closer to home, employing five highly experienced clinical pharmacists to support the duty doctors. In doing so, SELDOC is able to manage medication related queries and minor ailments without impacting on the duty doctors.

“This initiative not only frees up duty doctor time to deal with more complex medical issues but also provides patients with seamless access to medication during the out of hours period.”

Dr Riaz Jetha, Board Vice Chair & Chair of the Operations Committee

Bereavement Pack

SELDOC’s Clinical Governance Team identified a requirement for a bereavement pack to help duty doctors provide the relevant information in a sensitive, non-intrusive manner. The pack contains information on how to register the death, local funeral directors, ministers and spiritual leaders plus details on social security issues and where to seek help.

“We want our duty doctors to be the best they can be. By providing them with the tools and the training, we benefit both our partners and the patients we serve.”

Dr Paul Heenan, GP Board Director

Supporting the @Home Service

SELDOC is proud to be part of the Guy’s and St. Thomas’s @home initiative, developed to provide a ‘hospital at home’ pathway to help avoid unnecessary hospital admissions. Aimed principally at patients requiring more intensive medical support over a period of 2-10 days, the @home service assesses cases on referral in order to develop a care plan, overseen by both the hospital and SELDOC doctors via as many as four home visits per day.

The @home service can initiate blood tests, provide interventions such as IV rehydration or oral antibiotics, conduct a mobility or social assessment and link to other healthcare providers where necessary.

“The benefit of the @home service for the frail, the elderly or those recently discharged (but still requiring medical care) is enormous. By enabling them to recover at home, in an environment where they feel comfortable, with access to the appropriate care, we are helping both our patients and our partner hospitals.”