Dr Alan Rogers. Chairman

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It has been another year of progress for SELDOC. We have pursued our aim to provide a high quality service to our patients. We have made significant improvement towards meeting the National Quality Requirement Standards. The Clinical Governance Team formed last year has produced further Clinical Newsletters on various clinical issues to help improve the knowledge of our clinical workforce. We have developed parameters for introducing performance management for all our staff. My sincere thanks go to all members of staff for making SELDOC a success. Dr Alan Rogers. Chairman

This annual report sets out a number of service developments and the credit for these goes to our employees and to the performance, enthusiasm and dedication of those GP members who regularly work shifts at SELDOC This year has been a busy demanding year, where SELDOC proved to be a vital part of the health economy, an example being that of providing support to practices that could not open during the severe weather conditions in February 2009. SELDOC produced another excellent set of financial results and operational performance in a challenging and changing environment through strong focus on the management of our quality care and additional business. As part of the continuous improvement, SELDOC will be introducing performance measurement parameters based on benchmarks for all staff, GPs and other healthcare professionals working for SELDOC in the future. The aim is to be innovative and to ensure that a high level of productivity is achieved in meeting the National Quality Requirements and being complaint with the requirements for Standards for Better Health by March 2010. This will require additional investment in staff resources. In the current changing and challenging environment, our overall strategy and the way we do business will need to be under constant review to deliver the best care for our patients. SELDOC will need new investment in equipment and staff resources if it is to meet the challenges for the future. I would like to take this opportunity to thank the Board of Directors for their support during the year and pay tribute to the Council members, GP members and all the staff for their hard work. Yashwant Patel Chief Executive

5 The financial year 2008-2009 has been a year full of achievements, thanks to the staff and GP members who were totally responsible for this.

Extension of Contract agreed for opted out practices The shortfall of historic subsidy has been absorbed by SELDOC without increasing subscriptions. However, there will be a longer term impact on the finances of SELDOC and subscriptions may need to be reviewed. SELDOC was also able to secure an extension for the Opted Out contract. Dental Contract SELDOC continue to provide the service of Dental advice and triage to patients from SE London on phone. This service is handled by our experienced local dental nurses. 14240 patients called in the last year which means that the use of the service has increased by 58.9% over the previous year. There has also been a significant reduction in the numbers of patients referred to Kings A&E to less than 1%. 40.2% of cases were finished by nurses as advice.

Investment to provide responsive and better healthcare Fleet Cars Our investment this year included upgrading our fleet of vehicles, with Honda Civic Hybrid vehicles. The new vehicles have been fitted with a new light system which now has side spot lights, to assist in allowing door numbers to be seen from the cars at night. Choosing the hybrid option allowed us to continue to make our contribution to reducing carbon footprint. Information Technology Investment in Adastra V3 Aremote system was introduced seamlessly and allows the doctor to remain in contact with our base and receive home visit referrals whilst on the move.

I am grateful SELDOC exists and have been helped on several occasions satisfactorily. Improvement can only make (what in my opinion is) a good service even better. Very admirable and 100% Satisfied with SELDOC doctors. I have never used this service before and too be honest I expecting it to be as excellent as it was. I am very pleased Excellent liaison with Kings College Hospital, who had discharged the patient only the day before. Also further discussions with University Hospital Lewisham before agreeing course of action. I cannot thank you enough for the service offered and trust you will pass on my appreciation to the doctor who paid the house call. I was very happy with the care received from the doctors who visited me. They were here very promptly, and both were excellent. If you could thank them on my behalf I would be very grateful. I was greatly relieved and reassured by the doctor, I am thankful for this service at home as I am blind and disabled. The doctor was very helpful, friendly and reassuring. I was very impressed with the service.

The Road Ahead... An overview of SELDOC s plans for the coming year Patient environment We understand how important the surroundings are for a patient waiting to see a doctor. So we are working hard at improving the environment at our Dulwich Hospital Treatment Centre, we have introduced a receptionist to greet and assist patients on arrival. We have also installed a television in the main reception area to create a more friendly setting. improved environment at We will continue to look at developing ways to enhance the patient s experience when using our service and visiting our treatment centres. The voice of the patient is important to delivering our service and we will continue to use patient feedback and comments to improve the service that we deliver and also look at different ways of letting the patient know that their comments and feedback has made a difference to the way that the service is provided. Upgrading technology Further to going paperless SELDOC have now extended this to our cars introducing Aremote toughbooks computers for the doctors to enhance the delivery of service to the patient. Our vehicles are fully ITenabled with MPS systems, so doctors can send and receive information on the move. As a result reporting has improved as full consultation notes can be automatically sent to patients GPs by the new system. This has improved the information flow with faster, more efficient communications and a reduced risk of data entry errors and environmental benefits. SELDOC has also invested in a home working solution which allows doctors to work remotely from our treatment centres in our continued drive to improve patient experience. We have also introduced Web View which allows doctors in surgeries to extend patient care plans during their contact out of hours. SELDOC have also recently upgraded our IT hardware to Cluster and Citrix servers that allow us to share more complex information, more quickly, across more sites. Palliative Care Pilot At the beginning of August, SELDOC embarked on providing an innovative and much needed service to palliative care patients out-of hours access to medication. It will be a six month pilot for Lambeth, Southwark and Lewisham PCTs and supported by the South East London Cancer Network. New & more integrated services Throughout the coming year we are focusing on delivering on performance and quality. SELDOC will face many challenges in the coming year, In order to meet those challenges developing new business opportunities, but our main focus will be dedicated to delivering on performance and quality. Skilled staff, plus the right policies & processes Standardising processes and policies brings an improved quality of service for patients, so we are working hard with our staff on developing and expanding these. Advanced training for call handlers and our other staff on the new technology, plus other areas, will increase skill levels and boost service provision further. And it doesn t end there There are many other projects in the pipeline for SELDOC as challenges for patients having access to health sets the pace for the way ahead. Lord Darzi s review for healthcare in the future brings the introduction of GP Led Health and Urgent Care Centres. Out of Hours dental triage Improved service delivery home working solutions our new base Improved end of life Palliative care access to medication improved Completely paperless system clinical Aremote toughbooks In car system governance

Summary of Accounts Profit and Loss Account for the year ended 31st March 2009 2009 2008 Notes TURNOVER 3,365,805 3,241,188 Cost of sales 1,864,217 1,735,756 GROSS PROFIT 1,501,588 1,505,432 Administrative expenses 1,131,453 930,702 370135 574,730 Other operating income 90,348 93,772 OPERATING PROFIT 2 460,483 668,502 Interest receivable and similar income 79,439 109,392 PROFIT ON ORDINARY ACTIVITIES BEFORE TAXATION 539,922 777,894 Tax on profit on ordinary activities 3 17,968 21,878 PROFIT FOR THE FINANCIAL YEAR AFTER TAXATION 521,954 756,016 The notes form part of these financial statements

South East London Doctors Co Operative Limited Balance Sheet 31st March 2009 2009 2008 Notes FIXED ASSETS Tangible assets 4 84,623 118,550 CURRENT ASSETS Debtors 5 585,483 247,310 Cash at bank and in hand 3,094,778 2,632,089 CREDITORS 3,680,261 2,879,399 Amounts falling due within one year 6 428,182 370,521 NET CURRENT ASSETS 3,252,079 2,508,878 TOTAL ASSETS LESS CURRENT LIABILITIES 3,336,702 2,627,428 GOVERNMENT GRANTS 8 321,338 134,018 NET ASSETS 3,015,364 2,493,410 RESERVES Profit and loss account 9 3,015,364 2,493,410 3015364 2,493,410 These financial statements have been prepared in accordance with the special provisions of Part VII of the Companies Act 1985 relating to small companies and with the Financial Reporting Standard for Smaller Entities (effective January 2007).

Auditor s Report We have audited the financial statements of South East London Doctors Co Operative Limited for the year ended 31st March 2009 on pages six to ten. These financial statements have been prepared under the accounting policies set out therein and the requirements of the Financial Reporting Standard for Smaller Entities (effective January 2007). This report is made solely to the company's members, as a body, in accordance with Section 235 of the Companies Act 1985. Our audit work has been undertaken so that we might state to the company's members those matters we are required to state to them in a Report of the Auditors and for no other purpose. To the fullest extent permitted by law, we do not accept or assume responsibility to anyone other than the company and the company's members as a body, for our audit work, for this report, or for the opinions we have formed. Respective responsibilities of directors and auditors The directors' responsibilities for preparing the financial statements in accordance with applicable law and United Kingdom Accounting Standards (United Kingdom Generally Accepted Accounting Practice) are set out on page two. Our responsibility is to audit the financial statements in accordance with relevant legal and regulatory requirements and International Standards on Auditing (UK and Ireland). We report to you our opinion as to whether the financial statements give a true and fair view and are properly prepared in accordance with the Companies Act 1985. We also report to you whether in our opinion the information given in the Report of the Directors is consistent with the financial statements. In addition we report to you if, in our opinion, the company has not kept proper accounting records, if we have not received all the information and explanations we require for our audit, or if information specified by law regarding directors' remuneration and other transactions is not disclosed. We read the Report of the Directors and consider the implications for our report if we become aware of any apparent misstatements within it. Basis of audit opinion We conducted our audit in accordance with International Standards on Auditing (UK and Ireland) issued by the Auditing Practices Board. An audit includes examination, on a test basis, of evidence relevant to the amounts and disclosures in the financial statements. It also includes an assessment of the significant estimates and judgements made by the directors in the preparation of the financial statements, and of whether the accounting policies are appropriate to the company's circumstances, consistently applied and adequately disclosed. We planned and performed our audit so as to obtain all the information and explanations which we considered necessary in order to provide us with sufficient evidence to give reasonable assurance that the financial statements are free from material misstatement, whether caused by fraud or other irregularity or error. In forming our opinion we also evaluated the overall adequacy of the presentation of information in the financial statements. Opinion In our opinion: - the financial statements give a true and fair view, in accordance with United Kingdom Generally Accepted Accounting Practice applicable to Smaller Entities, of the state of the company's affairs as at 31st March 2009 and of its profit for the year then ended; the financial statements have been properly prepared in accordance with the Companies Act 1985; and the information given in the Report of the Directors is consistent with the financial statements.