BPAS - Sandwell

Updated 24 May 2022

British Pregnancy Advisory Service (BPAS) Sandwell provides a termination of pregnancy service in Sandwell and for the surrounding areas. The service provides termination of pregnancy as a single speciality service. BPAS Sandwell offers consultation, medical assessment, early medical abortion up to nine weeks and six days and surgical termination of pregnancy up to 13 weeks and six days weeks gestation, service specific counselling and treatment. As part of the care pathway, women are offered sexual health screening and contraception. Surgical termination of pregnancy can be undertaken under conscious sedation or local anaesthetic according to patients wishes.

The service is registered to provide the following regulated activities:

• Termination of Pregnancy.
• Family Planning Service.
• Treatment of Disease, Disorder or Injury.
• Diagnostic Imaging Services.
• Surgical procedures.

Under these activities the service provided:

• Pregnancy Testing.
• Unplanned Pregnancy Counselling.
• Early Medical Abortion.
• Surgical termination of pregnancy (SToP).
• Abortion Aftercare.
• Sexually Transmitted Infection (STI) testing and treatment.
• Contraceptive advice and supply.

The government legalised / approved the home-use of misoprostol for medical abortion in England from 1 January 2019. On 30 March 2020, the Secretary of State for Health and Social Care made two temporary measures that superseded this previous approval. These temporary arrangements were aimed at minimising the risk of transmission of coronavirus (COVID-19) and ensuring continued access to early medical abortion services during the COVID-19 global outbreak. The temporary arrangement meant that:

Pregnant women (and girls) would be able to take the two medicines used, Mifepristone and Misoprostol for early medical abortion, up to nine week and six days gestation, should they meet the eligibility criteria, in their own homes without the need to first attend a hospital or clinic.

It is possible for a medical practitioner to provide a remote consultation and or prescribe medicines for an early medical abortion from their own home. rather than travelling into a clinic or hospital to work.

This service has had three registered managers since its registration in December 2019. The current registered manager had been registered since May 2021 and is also the registered manager of another two BPAS registered locations.

Updated 24 May 2022

BPAS Sandwell is operated by British Pregnancy Advisory Service and was inspected as part of the Care Quality Commission (CQC) comprehensive inspection programme. BPAS Sandwell has not been inspected since it was registered in December 2019.

From March 2021 to February 2022, the service completed 695 medical abortions and 187 surgical abortions.

Prior to the inspection, inspectors reviewed monitoring and ongoing information about the service.

We rated it as requires improvement because:

• Women did not have timely access to the service and had to wait longer than national guidance both for consultation and treatment.
• The service did not ensure secure or appropriate storage and collection of pregnancy remains.
• The service did not use a paediatric specific risk scoring tool for girls under the age of 16.
• Completion of venous thromboembolism risk assessments did not always meet the providers policy.

However

• The service had enough staff to care for women and keep them safe. Staff had training in key skills, understood how to protect women from abuse, and managed safety well. The service controlled infection risk well. Staff kept good care records. Most medicines were managed well. The service managed safety incidents well and learned lessons from them.
• Staff provided good care and treatment and gave women pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent. Staff worked well together for the benefit of women, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information. Key services were available seven days a week.
• Staff treated women with compassion and kindness, respected their privacy and dignity, took account of their individual needs. They provided emotional support to women, families and carers.
• The service made it easy for people to give feedback.
• Leaders ran services well using reliable information systems and supported staff to develop their skills. Staff understood the service’s vision and values, and how to apply them in their work. Staff felt respected, supported and valued. They were focused on the needs of women receiving care. Staff were clear about their roles and accountabilities. The service engaged well with women to plan and manage services and all staff were committed to improving services continually. Required notifications were made to meet legal requirements.

Updated 24 May 2022

We rated it as requires improvement for a summary of our findings please see the overall summary at the beginning of this report.