SELDOC OOHs Hanover House

Updated 29 May 2023

SELDOC OOHs Hanover House is the base hub for an out of hours service and a category three ambulance revalidation service. A category three dispatch is where urgent treatment is required, normally in relation to a pre-existing condition that is neither immediately life threatening or serious in nature. The out of hours service is based in South-West London and is subcontracted from another provider, PPG. The ambulance revalidations is subcontracted from London Ambulance Service, who provide 111 service in South East, North East, and North West London The location is based at 76 Coombe Street, Kingston-upon-Thames, KT2 7AZ. The out of hours service is provided at St George’s Hospital in Tooting, and at St Helier Hospital in Sutton. The category three ambulance work is undertaken by staff who work either from home or the Hanover House site. The provider is SELDOC who have responsibility for a further out of hours service in London.

At both hospitals, the service has access to a reception area and up to two consultation rooms that are shared with the hospital provider. The service utilises its own medicines and equipment, but all upkeep of the premises is the responsibility of the Hospital Trust. The service does not provide home visiting.

The service covers a large urban area across London, with large populations of both high and low deprivation.

The service manages between 3,000 and 4,000 ambulance revalidations per month, and approximately 800 face to face consultations at the two hospitals per calendar month.

The service is registered with the CQC to provide the regulated activities of Transport services, triage and medical advice provided remotely and Treatment of disease, disorder or injury.

During the inspection we utilised a number of methods to support our judgement of the services provided. For example, we interviewed staff, and reviewed documents relating to the service.

To get to the heart of patients’ experiences of care and treatment, we always ask the following five questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions therefore formed the framework for the areas we looked at during the inspection.

Updated 29 May 2023

We carried out an announced comprehensive inspection at SELDOC OOHs Hanover House on Thursday 27 April, and Tuesday 2 May 2023. Parts of the service had previously been inspected as standalone locations prior to the registration of the service a hub and satellite service. This is the first inspection of the service at its current location.

This service is rated as Good overall.

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

At this inspection we found:

• The service had good systems to manage risk so that safety incidents were less likely to happen. When they did happen, the service learned from them and improved their processes.
• The service routinely reviewed the effectiveness and appropriateness of the care it provided. It ensured that care and treatment was delivered according to evidence- based guidelines.
• Staff involved and treated people with compassion, kindness, dignity and respect.
• Patients were able to access care and treatment from the service within an appropriate timescale for their needs.
• There was a strong focus on continuous learning and improvement at all levels of the organisation.

We saw one area of outstanding practice:

• The service undertook revalidations of instances where the Pathways 111 operating system had indicated that a category three ambulance dispatch was required. The performance of the category three ambulance revalidations at the service was such that in the last six months, only 8% of Pathways validations required an ambulance, with the remainder of patients either closed by the consulting GP with advice or a prescription, or the with the patient being sent to other services. This significant reduced the demand for the ambulance service.

Dr Sean O’Kelly BSc MB ChB MSc DCH FRCA

Chief Inspector of Hospitals and Interim Chief Inspector of Primary Medical Services