Updated 4 November 2022
BPAS Birmingham Central is operated by British Pregnancy Advisory Service (BPAS). The service provides a termination of pregnancy service in Birmingham.
The service is provided from a building leased by the service. The service provides termination of pregnancy as a single speciality service. BPAS Birmingham Central offers consultation, medical assessment/scanning, early medical abortion, medical termination of pregnancy and counselling through counsellors not on site. Treatment options are determined by the gestation of pregnancy and patient choice. As part of the care pathway, clients are offered sexual health screening and contraception. The service does not provide surgical termination of pregnancy and therefore we have not reported on this. However, if patients presented with later gestation, they were referred to another clinic that provided surgical termination of pregnancy.
The service also operates a TeleMedical Hub, which is a remote/digital early medical abortion services referred to as ‘Pills by Post’. This service is available for clients of all ages and for medical termination of pregnancy up to nine weeks and six days. Young clients aged 16 and under were required to have a scan to access this service. For young clients aged between 17 years and 18 years the provider has a scan algorithm which establishes if the client is suitable for pills by post.
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
Under these activities the service provided:
• Pregnancy Testing
• Unplanned Pregnancy Counselling
• Early Medical Abortion (EMA) (up to 9 weeks and 6 days gestation)
• Medical termination of pregnancy (MToP)
• Abortion Aftercare
• Sexually Transmitted Infection (STI) testing and treatment
• Contraceptive advice and supply
The government legalised / approved the home-use of Misoprostol 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 On 30 March 2020, the Secretary of State for Health and Social Care made two temporary measures that superseded this previous approval.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 would be able to take both Mifepristone and Misoprostol for early medical abortion, up to 9 week and 6 days gestation, 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 medication for an early medical abortion (EMA) to women in their own home rather than travelling into a clinic or hospital. On 30 March 2022, this arrangement was made permanent.
Activity
In the 12 months prior to our inspection from 1 July 2021 to 30 June 2022, the service completed 8,042 EMA abortions by telemedicine (remote consultation and supply of abortifacient medicines to take at home) and 1,444 EMA abortions at Birmingham Central. There were 139 EMA abortions for clients under 18 years of age.
The service was last inspected in July 2019.The inspection highlighted two areas where the provider needed to make improvements. These included ensuring client files contained completed VTE risk assessments and consolidating records to either paper-based or electronic. NICE guidance says all surgical patients and medical patients with severely reduced mobility should be assessed for their risk of developing VTE. During this inspection we found the service was no longer providing surgical abortion or vasectomies so VTE assessments are not routinely required. Records have been consolidated and electronic records were used.