Archived: SELDOC OOHs at Kingston Hospital

Updated 9 July 2018

South East London Doctors On Call (SELDOC, the provider) is commissioned to provide a range of GP out of hours services in South London. In South West London, SELDOC Out of Hours Service at Kingston Hospital is one of seven hubs at which patients may attend. There is a single hub that has administrative oversight for the area. Governance arrangements are co-ordinated locally by service managers and senior clinicians for each of the seven service locations, including the service provided from SELDOC Out of Hours Service at Kingston Hospital.

SELDOC Out of Hours service at Kingston Hospital operates from two clinical rooms within Kingston Hospital, Galsworthy Road, Kingston, KT2 7QB. During the day the two adjacent rooms are used for clinics by the hospital Trust, and out of hours the rooms accommodate one receptionist and one GP. Patients have access to toilet facilities and seats in a corridor waiting area. The service is on one level and is accessible to those with poor mobility.

The service is open between 8pm and 10.30pm Monday to Thursday, 8pm to Midnight on a Friday, from 8am until midnight on a Saturday and bank holidays and 8am to 3pm and 4pm to 10pm on a Sunday. Patients can only attend the service with referral through the NHS 111 service. On average the service sees 102 patients per week, mostly at weekends.

The service is led by a service manager (who is based at SELDOC’s headquarters), and there is a GP on site who has oversight of the out of hours service. Team Leaders are also available via telephone at the service headquarters to address any problems staff may face.

GPs working at the service were either bank staff (those who are retained on a list of employed staff by the provider and who work across all of their sites) or agency staff. The site had permanently employed part time reception staff.

The service is registered with the Care Quality Commission (CQC) for the regulated activities of treatment of disease, disorder or injury, and transport services, triage and medical advice provided remotely.

Updated 9 July 2018

This service is rated as Good overall. The service was previously inspected by the CQC on 3 August 2017. At that inspection the rating for the service was good overall. This rating applied to effective, caring, responsive and well led and all six population groups. Safe was rated as requires improvement.

The report stated where the service must make improvements:

• Develop effective systems and processes to ensure safe care and treatment including ensuring the proper and safe management of medicines, and assessing the risk of not providing Oxygen and Automatic External Defibrillator on service vehicles used for home visits and, where appropriate, mitigate their absence.

The key questions are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? – Good

We carried out a focused inspection of the SELDOC Out of Hours Service at Kingston Hospital on 21 May (visiting both the hub centre and the main site). The focussed inspection was to check if areas within the safe domain which were in breach of CQC regulations were now resolved

At this inspection we found:

• Cars used by the service had Oxygen and an Automatic External Defibrillator available for use.
• The service utilised prescriptions where GPs provided medications to patients directly in line with guidance.
• The service had implemented new systems for how medicines were supplied to the site. Stocks were monitored and relevant drugs were available.
• Medicines audits had been completed and the service showed improved antibiotic prescribing following audits.

Professor Steve Field CBE FRCP FFPH FRCGP
Chief Inspector of General Practice