29 January 2020
BPAS Streatham is operated by British Pregnancy Advisory Service. The British Pregnancy Advisory Service is a British charity whose stated purpose is to support reproductive choice by advocating and providing high quality, affordable services to prevent or end unwanted pregnancies with contraception or by termination of pregnancy. The service is registered as a single specialty service for termination of pregnancy and is registered for the following activities:
Services provided at the early medical unit included:
- Unplanned Pregnancy Counselling/Consultation
- Sexually Transmitted Infection Testing
- Contraceptive Advice and Treatment
The service has had a registered manager in post since October 2018
29 January 2020
BPAS Streatham is operated by British Pregnancy Advisory Service. BPAS Streatham provides medical and surgical termination of pregnancy services, feticide treatment, screening for sexually transmitted diseases, contraception advice, counselling and vasectomy procedures. The service provides surgical terminations up to 23 weeks plus six days gestation and medical abortions up to nine weeks plus six days gestation. Facilities include one treatment room, five consulting rooms a two stage recovery area, and a discharge area. There was an early medical unit based within a health centre in Southwark. Early medical abortion treatment and consultations in the early stages of pregnancy were offered in a private room at this facility.
The service provides termination of pregnancy, sexual health screening and family planning services. We inspected this service using our comprehensive inspection methodology. We carried out the unannounced part of the inspection on 5,6,16,18 September 2019.
To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led? Where we have a legal duty to do so we rate services’ performance against each key question as outstanding, good, requires improvement or inadequate.
Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.
The main service provided by this hospital was termination of pregnancy services.
Services we rate
We rated it as Requires improvement overall.
We found areas of practice that require improvement:
There was a corporate governance structure in place, however this was not effective at local level. Local governance arrangements did not ensure the identification, mitigation and monitoring of risks or the improvement of quality. There was a fractious relationship between some leaders and staff, and staff did not always feel valued or supported. We were not assured information fed into the monthly dashboard was accurate.
The monitoring of staff mandatory training and competencies was not managed well. There was no formalised tracking until very recently, and this had yet to be embedded into the service. Not all staff had received an annual appraisal or regular performance reviews.
There was not a strong culture for the reporting and sharing of feedback from incidents. We were not assured incidents of all levels were being reported.
Waiting times from initial referral to treatment were not in line with Royal College of Obstetricians and Gynaecologists (RCoG) national guidance and Required Standard Operating Procedures (RSOP) 11: Access to timely abortion services. Patients could not always access the service when they wished. 54% of surgical termination of pregnancy patients above 14 weeks gestation, waited more than 10 days.
Not all equipment was in good working order or had been calibrated.
Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
The service had suitable premises and all areas of the clinic were visibly clean and clutter free. The clinic was wheelchair accessible with accessible toilets and a lift to all floors.
Staff completed patient records accurately and stored them safely.
The service treated concerns and complaints seriously and investigated them. The service included patients in the investigation of their complaint.
Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with one requirement notice that affected BPAS Streatham. Details are at the end of the report.
Deputy Chief Inspector of Hospitals
29 January 2020
BPAS Streatham is operated by British Pregnancy
Advisory Service (BPAS). It comprises one main
location in South London and one satellite
in Southwark. The service provides termination of pregnancy as a single speciality service. We rated this service requires improvement for safe, effective, responsive and well led and good for caring. Overall the service was rated requires improvement.