A RELENTLESS FOCUS ON CARE, COLLABORATION AND CLINICAL LEADERSHIP
This year, SELDOC commemorate our 25th anniversary, and to celebrate we’ve got a few things up our sleeves
We’re extremely proud to be a ¼ century old and have had a roller coaster journey across the years. Documenting this, we have put together an anniversary blog and visual timeline that showcases some of the exciting things we’ve achieved over the past 25 years, plus some milestones we’ve reached as a company.
In the early 1990s, the growing workload faced by GPs caused increasing damage to morale. One response was contractual changes that allowed practices to collaborate in the provision of out-of-hours (OOH) care, rather than be individually responsible.
In 1995, five GP facilitators from Lambeth, Southwark and Lewisham (LSL) were appointed by King’s College London to develop ideas for a GP-led OOH service.
As a consequence, in April 1996 SELDOC (South-East London Doctors On Call) was set up as a co-operative. With a council of 15 members chaired by a GP, and a GP-led management board, it began operations from an office in Dulwich Hospital. Around 110 practices across LSL signed up.
Right from the start, the focus was on the dedication with which we delivered care to people who needed it, at primary care centres, at home and over the telephone. Since its very earliest days, SELDOC has achieved high levels of patient satisfaction.
In 1996-97, we treated just under 58,000 patients; over the next 12 months, that number increased to more than 69,000. The first couple of years were challenging, and when the new chairperson took over in 1998, SELDOC had a large deficit – but within a year, the financial position was stable and GP compliance had been strengthened, amid many internal changes.
A review of OOH services in 2000 led to further significant changes, as well as full integration with NHS Direct. By 2002, the name SELDOC now stood for South-East London Doctors Co-Operative. The organisation achieved a DOH accreditation and rating of “excellent”, while meeting 33 quality standards out of 36.
In 2004, further contractual changes allowed GP’s the opportunity to opt out of OOH responsibility in exchange for a 6% loss in their contract value; however, more than 90% of practices remained opted in with SELDOC.
2005 saw a radical restructuring of SELDOC’s finances, as well as A&E pilot schemes at King’s and Lewisham Hospitals, as well as a new fleet of five cars. By now, 95% of local GPs had opted to partner with us.
SELDOC emerged from its restructure as a financially stable and forward-looking organisation as it celebrated its 10th anniversary in 2006. By now, SELDOC was serving 900,000 people across south-east London. As Lesley Humber, director of operations for local development at Southwark PCT, put it: “SELDOC has made a significant contribution to primary care delivery over the past 10 years.” This was also the year in which the OOH dental triage service was announced.
In 2007, SELDOC became the LSL access centre for patients who had difficulty in obtaining a GP appointment, while our integration with the Lewisham A&E department was also fully implemented.
There were further significant internal changes at SELDOC in 2009 following the introduction of National Quality Requirements with which all OOH providers had to comply. Dr Riaz Jetha was appointed on a six-month basis to develop a Clinical Governance Framework, and to appoint our first Medical Director. SELDOC moved from a council to a board structure, chaired by Dr Emma Rowley-Conwy, of eight GPs and two new non-executive directors.
SELDOC achieved Care Quality Commission (CQC) registration in 2012, a year in which our services within Lewisham A&E were redeveloped to offer OOH GP support to its new Urgent Care Centre. The next year, 2013, saw SELDOC tender successfully to supply an OOH service in Sutton for three years.
One patient said of the care they received that year: “The service is prompt, the staff caring and polite. I have had nothing but good care when I am poorly. I cannot rate it highly enough.” Indeed, patient feedback has been consistently positive over the years. In response to a 2014 questionnaire, 58% of patients felt their experience with us was “excellent” and another 29% described it as “good”.
In 2016, SELDOC relocated from Dulwich Community Hospital to Hanover House in Norbiton, as we became fully operational in the south-west London boroughs of Kingston, Merton, Sutton and Wandsworth. At the same time, we teamed up with Vocare (who provided the 111 element) to provide telephone consultations, face-to-face and home visiting OOH assistance in those four boroughs, with 120 practices opted to partner with us.
After 20 years in operation, SELDOC was still led by local GPs but was now a diversified, multi-million-pound business providing care for more than two million patients across seven CCG areas in South London in both the in- and out-of-hours periods. The Board, with a new CEO, and the Management Team worked hard to overcome financial challenges in 2017 to turn a deficit into a healthy surplus. This was also the year in which we introduced new front-line clinical roles such as pharmacists and nurse practitioners.
By 2018 our financial position was very strong, while we improved our clinical governance and were rewarded with a CQC rating of “good”. The growth and complexity of our operation were reflected in the appointment of additional NEDs to our board, which focussed on strategy, and with our ongoing programme of strengthening the management team with new hires.
In the 2018-19 financial year, turnover increased to £14.2million, with any surplus reinvested in the business. During 2019, the LSL service was reconfigured to allow for all calls to be initially triaged by 111.
The advent in 2020 of the Covid-19 pandemic led to a period of intense activity for SELDOC. We quickly set up a Covid Clinical Assessment Service (C-CAS) for patients. The huge demand on our services continued into 2021, but there was a sense of real achievement, with a relentless focus on helping patients through a very difficult time.
SELDOC had stepped up and responded well to the challenges of the COVID-19 crisis. Our financial position remained strong too, and we were able to return £3million in cash to GP members.
Few healthcare co-operatives like ours last as long as 25 years, nearly one-third of the lifespan of the NHS. As our Chair, Dr Riaz Jetha, has said: “Given the continual turbulence of NHS changes, it’s quite an achievement for a GP-owned clinically-led operation to remain so resilient.” That it has done so is due to the ongoing commitment and professionalism of everybody connected with the organisation. We are proud to be here and to be making a significant contribution to healthcare provision in the boroughs we serve – and we are confident we will be here for another 25 years at least.
Thank you for taking a moment to read this information. We hope you found it interesting. We would love to hear from you if you are interested in what we do and would like to find out a little more. With very best wishes from the SELDOC Team