BPAS Healthcare

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We found people were involved in decisions about their care. The service provided information people could understand. People knew how to give feedback and were confident the service took it seriously and acted on it. The service was easy to access and worked to eliminate discrimination. People received fair and equal care and treatment. The service worked to reduce health and care inequalities through training and feedback. People were involved in planning their care and understood options around choosing to not receive treatment.

We rated this key question good. This meant people’s needs were met through good organisation and delivery.

This service scored 79 (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 women were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Women’s care reflected their physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act. Staff made sure care and treatment was tailored to women including by making reasonable adjustments so women could access the service in a way and at a time that suited them. For example, women who worked could be offered appointments in the evening or weekend, and neurodiverse women could have longer appointments to give them time to process information and ask questions if they needed it.

Staff ensured women understood their care and treatment options which included not having a termination of pregnancy. Staff told us they were responsive to people and would support them in way that met their changing needs. For example, people who had a longer gestation of pregnancy than expected which meant they could no longer have their preferred abortion treatment. Or people who were undecided about abortion treatment and needed additional time and support to make choices about their treatment.

Staff ensured they involved both women seeking treatment, and those close to them in planning and making shared decisions where the women wanted this to happen. This meant treatment was centred around the women and their needs.

We listened to a call where a women wanted to know about their treatment options but was scared about making the wrong decision. The midwife explained the treatment options but said that the decision to go ahead with treatment, or not, could be made in the woman’s own time. They went on to explain the timeframes that abortion treatment could take place in and reassured the woman they still had time to make the decision that was right for them. They told the woman they would email them leaflets about treatment options and timeframes so they did not have to remember all the information they were getting all at once. They offered a referral to pre-abortion counselling.

If women were referred for a surgical termination they were advised that some of the doctors might be male.

The service understood the diverse health and care needs of people, so care was joined-up, flexible and supported choice and continuity.

Women’s care and treatment was delivered in a way that meet their assessed needs. While most appointments lasted an average of 60 minutes there was flexibility within the appointment list for each day to allow extra time for women who need it. For example, women who required an interpreter, or women who needed additional time to process information about their treatment choices.

Young women were prioritised for appointments outside of school hours but could be booked into any available consultation appointment slot.

Each day some appointment slots were held for women who needed an urgent appointment.

The service worked in partnership with prison services and mental health providers to ensure women in custody, women in immigration centres and women subject to the Mental Health Act (1983) could access the service and receive appropriate monitoring in a suitable environment for the duration of their abortion treatment.

The organisation was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service provided online and written information about the services they offered including abortion treatment, screening for sexually transmitted disease and contraception. Written information was also available in easy read formats.

There were videos on the organisation’s website that talked through what the service offered as well as step-by-step instructions for using abortion treatment at home as well as information about surgical treatment. The step-by-step instructions included what the pack of medication looked like, how to use the medication, the use of pain relief, and what to expect during and after treatment. All the web-based videos had closed captions, and some had British Sign Language interpretation.

All women undergoing medical abortion treatment were given a leaflet with detailed step by step instruction of how and when to use their medicine, how long treatment would take and what would happen afterwards. The leaflet also provided information about the risks involved in treatment and what to do if something did not feel right or in case of emergency. The leaflets were available in brail and electronic versions of the leaflet were available in 60 languages other than English.

Women were asked to complete a satisfaction survey following their treatment. There were 517 responses from January to March 2025. The feedback showed 99.2% of women felt they had been provided with clear explanations about treatment, and 98.8% of women said they given enough time to ask questions. Responses also demonstrated 97.3%of women said they were given enough information about aftercare. The comments were typically positive. For example, comments from January read, “I don't believe anything could have been done better. I didn't feel pressured, my options were explored and I was offered counselling to be sure this was the right decision.” “A member of staff talked me through everything. I was scared as I've never been through this process before I didn't know what to do when I first called up. She wasn't judgmental, she talked me through everything I needed to know, asked me if there was any concerns or if I had anything I wanted to talk about. The support offered was great. I'm glad there's a service out there like this where women can feel comfortable about the choice they make with their body.”

Comments from February 2025 included “the person I spoke to explained everything. Thank you so much.” and “All of my queries and questions were answered in my consultation.”

Comments from March 2025 included the following statements. “The midwife I spoke to at my consultation was incredibly knowledgeable, supportive and understanding. At no point was I made to feel stupid or small for the decision I was making. I felt completely at ease having had a hard and honest conversation about my treatment and my reasoning which again was met with understanding. I was offered all resources available and when asked about resources for my partner I was also given helpful information for this too. The midwife took the time to ensure I was given all the advice necessary and made sure I understood it too as there is a lot to take in. I would like to thank every member of staff I spoke to for dealing with me with such compassionate care. This was not an easy decision for me, and I was reassured and supported from beginning to end.” “My experience was fantastic from start to finish. I felt well-cared for, supported, and informed throughout the entire process. Please keep up the amazing work.”

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

Staff told us there was also a process for learning from complaints. As well as identifying key themes and trends in complaints at staff meetings managers also discussed the actions taken to address complaints so staff had an enhanced understanding of the impact of women’s experience went things had not gone as planned. Staff said this process helped them “close the loop” on their learning.

From March 2024 to March 2025 the number of complaints made reflected 0.2% of women assessed for treatment. Most complaints related to information or communication problems. Other complaints included problems with postal delivery of ‘pills by post’ (3), and issues with booking appointments (3). In response to complaints, women were kept updated on the outcomes of investigations and notified of any changes to their care pathway or any learning taken.

Women were asked to complete a satisfaction survey following their treatment. They were sent a text with a free text response to share their comments and concerns about the service. Managers met monthly to look at the feedback and consider how changes to service delivery could improve women’s experience of treatment. Trends and themes in feedback were also shared with staff so they could be taken forward as quality improvement projects.

The service made sure that people could access the care, support and treatment they needed when they needed it. Women had equal access to care, treatment and support because the provider complied with legal equality and human rights requirements, including avoiding discrimination, considering the needs of people with different protected characteristics and making reasonable adjustments.

The service was designed to make it accessible and timely for people who were most likely to have difficulty accessing care. When there were barriers, the service worked to remove them. Most referrals were made from women directly accessing treatment themselves (less than 1% of referrals were made by a woman’s GP). Information about how to access the service was displayed on the organisation’s website. The website had a facility which meant it could be translated into 60 of the most commonly spoken languages in the United Kingdom. The website also had functions to enable users with vision impairment to use assistive technology, including a text only version of the website.

To ensure treatment was accessible to as many women as possible there was information on the providers website about requesting additional support for people who needed it. People with communication needs were asked to let the booking team, helpline teams, or clinic staff know. A textphone service was also provided for calls to the booking team and helplines.

Managers ensured women could access the service out of hours to enable wider access as required. The service offered evening and weekend face to face and telephone assessment appointments.

The capacity team worked within the telemedical hub to monitor demand on the service. Appointment slots held for women who needed an urgent appointment were opened to everyone if they had not been booked about an hour before their start time. These appointments could also be used if another hub had a high level of demand for appointments for women under 18 or for those requiring an interpreter.

Access to treatment was delivered in line with national guidance, including the National Institute for Health and Care Excellence (NICE) and the Royal College of Obstetricians and Gynaecologists. The guidance recommends assessment for abortion should be accessed within 7 days of making contact with an abortion service. Completion of abortion treatment should take place within 14 days of the initial contact for most women.

Managers told us they have never had to cancel a woman’s appointment. If the local team had sudden sickness absence they would reach out to 1 of the other telemedical hubs and ask for their support. They described a reciprocal agreement across the 5 hubs.

Women made initial contact with the organisation’s booking centre. If the booking centre identified quick access to an appointment was required, this would be passed to the accelerated booking team. This team would contact the managers to look at how this appointment could be expedited so the woman could be assessed within 48 hours.

If a woman needed financial support to access the service a request for funding was made to their integrated care board (ICB). This could be for help with transport costs or covering the cost of pain relief not provided by the service.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff had a good understanding of the people who used their service that were most likely to experience inequality in experience or outcomes, and they took steps to minimise barriers to inclusion and positive experiences. Data collected from the provider demonstrated that women of different ages, religious and spiritual backgrounds, as well as women from a diverse range of ethnic backgrounds accessed the service. The data also showed the service was used by a diverse range of women with appointments being inclusive to all. Staff received training to support them to work with all women, including those with protected characteristics.

The service took action to prevent or minimise the inequality in experience or outcomes for people. They did this by making reasonable adjustments for people and providing culturally appropriate care.

Staff worked in partnership with other agencies to improve equity in access and outcomes. For example, they worked with professional translators to improve the experience of treatment for people whose first language was not English.

Where waiting times were longer, managers reviewed this and reallocated appointments “to avoid a postcode lottery”. If there was more demand in one area than another or if one area had a high level of sickness, the telemedical hubs would provide support for each other.

Feedback from women who use the service from January, February and March 2025 showed 74.7% of them felt the leaflet they had been given completely prepared them for pain they were going to experience. A similar number of women (73.5%) said the website had prepared them for this. However, 28% of women said they experienced more pain than expected. In response to this feedback a member of the team completed a research project on pain.

Feedback showed some women felt completely prepared to undergo abortion treatment but that they also experienced more pain than they expected. A deep dive into the data revealed that the women most likely to experience more pain than they expected had not had a previous birth, miscarriage, or a previous termination of pregnancy. In light of these findings this patient group would be given additional information about what to expect. They changed some of the information on videos on the website and in the step by step leaflet all women were given a copy of. For example, they introduced images of blood loss to give a visual interpretation of what a heavy blood flow looks like rather than leaving this up to an individuals interpretation. We heard NMPs being descriptive about blood loss to improve women’s understanding of the procedure and to help them gain a realistic expectation of what their treatment might look and feel like. Staff were waiting for the end of that quarter’s feedback so they could measure the improvement the new videos and leaflet made. However, staff were aware they still had more work to do to improve women’s understanding of how much pain they were likely to experience.

Some women had unsuccessful treatment outcome (failed abortion treatment). When this was reported back to the provider staff carried out an investigation into what went wrong to help reduce the likelihood of things going wrong for other women. The investigations showed there were several reasons this might happen, but mostly it was because women had not used their medicine as directed. To increase the number of successful abortions NMPs asked women to repeat back to them instructions for using their medicines to ensure women understood the directions they had been given. NMPs spent extra time with women to explain to how to use their medicine if they thought this was necessary.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

Women were not asked to make a decision about having treatment until they felt ready to do this. Women were given advice and information about terminating their pregnancy, including on the timescales within which medical and surgical abortions could take place. However, they were not under any pressure to decide within a timescale. The options of having a termination of pregnancy, adoption, or going ahead with the pregnancy were discussed. Women were offered counselling to help them make a decision, and they could be sent information to help them to make a choice in their own time without the pressure of remembering the treatment choices that had been discussed.

Women were advised they could make use of the organisation’s post abortion treatment counselling at any point in the future.

To meet local needs and improve health outcomes women were given advice about sexual health screening and signposted to their local sexual health services. Women were also asked about contraception and given information and advice about their contraception options taking their personal circumstances and beliefs into account. The provider could offer contraception as part of woman’s treatment pathway or signpost them to their local services.