It may be one of the largest social enterprise healthcare providers in the country but the South East London Doctors' Co-operative (SELDOC) is determined to grow.

Formed in 1996 by local GPs out of concern for the quality of out-of-hours care for patients, it has become a major force for improving standards and innovating care systems in the NHS.

It has just started a three-year programme to provide dental triage service and has ambitious plans to extend its patient-focussed approach across a range of disciplines.

"We have done very well in the past but we are keen to push on because we know we can bring in procedures that will help the patient while being cost effective for the NHS," says chief executive Yashwant Patel (pictured right).

"We are constantly looking at new and innovative ways of working that would provide continuity for patients. If we can do that we can give the population a better and more relevant service - patients will be provided the service closer to where they need it."

SELDOC is a unique co-operative enterprise managed and financed by nearly 600 GPs across 125 practices that provide out-of-hours care to tens of thousands of patients across South East London.

The service, based in Dulwich Community Hospital, broke the mould when established by its initial band of 120 doctors in three London boroughs. Its business model dismantled an unwieldy and costly system that mixed GPs and private firm medical cover. SELDOC's intention was to take the service back to its roots but the methods also proved profitable.

Member practices are charged per patient which funds the on-call fees for the GPs. Profits are ploughed back into the co-operative. The system was an instant hit with the local population and also enabled doctors to keep in touch with patients who might have been dealt with by commercial on-call GPs from different areas.

SELDOC, which has won Investors in People and National Training Awards, employs 12 administrative staff and 40 call handlers and drivers. All its member GPs are contracted to undertake out-of-hours shifts each year.

It reaches a patient population of 900,000 and answers 60,000 calls a year via its 24-hour answering service which organises GP cover from 6.30 pm to 8.30 am weekdays and 24 hours at weekends and Bank Holidays.

SELDOC's policy decisions go through a Council consisting of the Chief Executive and  15 GPs drawn from the three boroughs to ensure all voices and concerns are taken into account

It is a limited company that acts as a non-profitable organisation and its turnover has reached £3.4 million. Profits are invested to help fund additional services and the ceaseless quest to improve the experience of the patient.

SELDOC's collective power also enables it to bulk purchase medical supplies such as flu vaccine and make savings. It offers training seminars for GPs with experts sharing their knowledge on specific illnesses and treatments. Information on local medical issues and opportunities are shared via a monthly newsletter.

 "We are developing ways of delivering care and medical services to the community and putting back into the community," adds Mr Patel. "We want to take the kinks out of the service. "We know that things can be frustrating so we want to provide services that are both comfortable for the patient and the GP; a service that is close to home and doesn't involve being pushed from pillar to post.

"We want to make the services integrated and take the problems out of the process. For instance, we don't want to see patients sent to hospitals only for the consultant to say the patient needs an x-ray and there is another two weeks to wait for the next appointment. We need to sort out exactly what is needed so it is seamless and a much easier journey for the patient and much more efficient for the health service."

SELDOC is developing a number of initiatives but faces stiff competition from private health care companies eager to win Department of Health contracts. "It is a very competitive business. We have the expertise and the commitment and if we make money it goes straight back into the health service. Some companies are in it for profit first," added Mr Patel, an accountant who has previously worked in Whitehall.

 "We are not afraid to have a business model for what we do but we always put patients before profit. We re-invest back into the community. If you get a company making £100,000 there is nothing to say they have to put it all back into the service.

 "We have business disciplines and are always looking to upgrade our systems such as IT and training because we want to be more efficient so we can put more money into other projects. But the best thing about SELDOC is the commitment of the GPs who started this off to benefit the public.

"SELDOC will always be run as a social enterprise and the results will always be to connect GPs, the population and the health service. That is true to the founding principles of the NHS and that is why it is so important that we push on with our work."

www.seldoc.co.uk