BPAS - Birmingham Central

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

People were involved in assessments of their needs. Staff took account of people’s communication, personal and health needs. Care provided to people was based on the latest evidence and good practice. Staff made sure people understood their care and treatment to enable them to give informed consent.

At the last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, wellbeing and communication needs with them.

Staff used a range of tools to assess and review people’s treatment needs. The tools were standardised, so staff understood how to use them. The assessment process enabled Nurse and Midwife Practitioners (NMPs) to understand women’s holistic needs and offer information about or make an onwards referral to internal or external support services. For example, they could give information about external services that supported victims of domestic abuse, violence, or sexual assault. They could also make internal referrals to the organisation’s counselling services for support with women’s abortion choices.

Women were asked about their communication needs when they first made contact with the service. If required women were provided with support by the service to overcome communication barriers.

Staff encouraged young people to consider who might be a supportive adult they could approach for support. They asked all people if they felt safe with the person they had an intimate relationship with and if they were being asked to do things they were unhappy with as part of the safeguarding assessment. However, staff were aware this might be the first time people, especially young people, had considered their sexual safety so they gave them as much time as they needed to reflect and answer this.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. Staff did this in line with legislation and current evidence-based good practice and standards.

Managers had regular meetings with their peers from across the organisation. At these meetings best practice was shared to ensure the clinics and telemedical hubs were using the same standards of care.

Staff used technology to support their clinical assessments of women. This supported the staff to make sound decisions based on professional judgment and best practice.

The organisation had a clinical advisory group which reviewed policies to ensure they incorporated up to date clinical practice. The clinical advisory group members included the organisation’s subject experts and the quality improvement matrons. Policies and procedures were stored on the organisation’s intranet and were available to all staff. When policies were updated, staff were given protected time to read them. Staff also received an email to let them know when a policy change was due.

Managers used the electronic patient record (EPR) to perform a monthly audit of assessment forms. This was to check all parts of the form had been fully completed to demonstrate all questions had been asked to ensure a holistic view of the woman had been formed.

NMPs completed peer reviews of each other’s case notes. They listened to each other’s calls and gave feedback on the quality of the call and notes recorded. This improvement exercise was aimed at sharing best practice. Staff fed back they found this a supportive learning experience that enabled them all to improve the quality of their note taking.

The service worked well across teams and services to support people. Staff made sure people only needed to tell their story once by sharing their information about their assessment of people’s needs when they moved between different services.

Electronic patient records could be accessed by relevant staff within the organisation. For example, information collected by the booking team, was also visible to the telemedical hub staff and clinic staff. This reduced the times staff needed to ask women the same questions.

NMPs worked closely with external teams including community midwives, safeguarding teams and sexual health services. They described strong working relationships based on trust that had been established for many years. Staff said safeguarding teams were always very responsive to their referrals, and in turn they aimed to respond promptly if they were asked for additional information about a woman and her situation.

One NMP told us they were working with a newly developed sexual health service for young people. The aim of the meeting was relationship building and an opportunity to explain the referral pathway and treatment offered by the service.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support.

The assessment included a discussion around women’s sexual health. Staff sent out testing packs for sexually transmitted infections (STIs) to eligible women. Women who were not eligible for this were given information about services local to them which offered this.

Women were asked about their use of contraception and were advised how they could access this through BPAS. Women were also advised how they could access contraception through their GP and local sexual health service.

There were pathways for women under the age of 18 and vulnerable adults. These women could be referred directly to their local sexual health service for support with contraception and STI testing if they consented to this. Staff could also refer women of all ages to their local sexual health clinic if they were reluctant to access STI treatment through their GP.

The service routinely monitored women’s care and treatment to continuously improve it. Staff ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The success rate of medical terminations was monitored by the organisation to improve outcomes for women. Staff monitored outcomes using a set of indicators. The service shared the data with their system partners. The main indicators included how quickly people could access an assessment of their needs (5 working days for a standard referral, 2 days for urgent appointments), access ultrasound scans (6 days), and how quickly their treatment pathway was completed (10 days). Other indicators included the percentage of people offered contraception, the number of people who took up testing for sexually transmitted diseases, and the number of incomplete abortion treatments. An incomplete abortion treatment is when the pregnancy continues despite medicines to terminate the pregnancy being used. In these cases, an additional procedure would be needed to complete the termination.

According to the National Institute for Health and Care Excellence (NICE) and the Royal College of Obstetricians and Gynaecologists the expected failure rate for early medical abortions is approximately 2-3%, or 2 to 3 out of every 100 cases. Between March 2024 and March 2025 there were 41 recorded cases of a failed early medical termination of pregnancy. This was lower (better) than the expected failure rate at 0.3%, or less than 3 in 1000, treatments.

The service identified where they could improve outcomes and worked to improve these. For example, to reduce the number of women not attending stand alone contraceptive appointments, staff started to see women for contraceptive appointments on the same day women attended for their termination of pregnancy appointment. This resulted in a higher uptake in contraception.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment.

Women were advised that under the Abortion Act 1967 it was a legal requirement for the provider to share anonymised information for people using their service for abortion treatment with the UK government’s Chief Medical Officer. The information shared included a unique reference number, date of birth, postcode, ethnicity, marital status, treatment details, gestation of pregnancy, and the legal grounds for the abortion. The legal grounds for abortion could only be granted if 2 doctors agree it would cause less harm to the woman's physical or mental health or the health of existing children than continuing with the pregnancy.

Gillick competence and Fraser guidelines were used to assess the ability of young people to consent to abortion treatment and sexual health advice and treatment. Gillick competence is concerned with determining a child’s (person aged under 16 years) capacity to consent through assessment of their intelligence, competence and understanding to fully appreciate what's involved in their treatment. Fraser guidelines were used specifically to decide if a child could consent to contraceptive or sexual health advice and treatment.

Staff gained verbal consent from women and recorded this in their electronic patient records. Interpreters were used to gain consent from women whose first language was not English, including for women who used British Sign Language.

Staff understood how to assess women’s capacity to consent to treatment. Staff knew how to work with women detained under the Mental Health Act (1983); women held in an immigration detention centre or women serving a prison sentence.

If a women lacked capacity to make decisions about her treatment, the case would be managed by the organisation’s safeguarding team.

A monthly audit was conducted to ensure staff were seeking women's consent to treatment. The audit for March 2025 demonstrated 100% compliance with seeking and recording consent in line with the organisation’s policy.