MSI Reproductive Choices National Treatment Centre - West London

Updated 1 August 2019

Marie Stopes International (MSI) West London Centre is part of the provider group Marie Stopes International, a not for profit organisation that was founded in 1976.

MSI West London Centre is contracted by Ealing, Hounslow, Hillingdon, Hammersmith and Fulham, Brent and Harrow Clinical Commissioning Groups (CCGs) to provide a termination of pregnancy service for the patients of West London and surrounding areas. The centre also accepts patient referrals from around the UK and abroad. The service receives referrals from general practitioners (GPs), hospitals, family planning services and another independent provider. Patients are also able to self-refer. The service treats adults and young people aged 14 and above. Young people aged 14-16 forms 2% of the patients treated at the centre.

MSI West London Centre also manages five satellite early medical units (EMU) located in the community in Guildford, Hemel Hempstead, Hillingdon, Watford and Wembley, where medical termination and consultations in the early stages of pregnancy are provided in a private consultation room.

The service provides surgical termination of pregnancy procedures up to 23 weeks and six days gestation as well as early medical abortion and medical termination of pregnancy up to nine weeks and six days gestation. Surgical termination of pregnancy is carried out under general anaesthetic, sedation, by vacuum aspiration or dilatation and evacuation or no anaesthesia for up to 10 weeks according to the patient’s choice or needs. The service also provides consultations, ultrasound scans, contraception advice including fitting of long acting reversible contraception (LARC), counselling and screening services for sexually transmitted infections. The service also provides a vasectomy service (male sterilisation).

The service is registered as a single speciality service and also provides the following regulated activities:

• Termination of pregnancy

• Family planning

• Treatment of disease, disorder or injury

• Surgical procedures

• Diagnostic and screening procedures

The service had two registered managers in post during the time of our inspection. One registered manager who was the operations manager had been in post since March 2018 and the other registered manager who was the deputy clinical services matron had been in post since May 2019. The operations manager and deputy clinical services matron provided dedicated on-site managerial support for operational and clinical issues.

Updated 1 August 2019

Marie Stopes International West London Centre is operated by Marie Stopes International. Facilities at the centre include two treatment rooms, five consulting rooms, ultrasound facilities, a waiting room and three day rooms including a recovery room with reclining chairs.

The service provides surgical termination of pregnancy procedures up to 23 weeks and six days gestation as well as early medical abortion and medical termination of pregnancy up to nine weeks and six days gestation. Surgical termination of pregnancy is carried out under general anaesthetic, sedation, by vacuum aspiration or dilatation and evacuation or no anaesthesia for up to 10 weeks according to the patient’s choice or needs. The service also provides consultations, ultrasound scans, contraception advice including fitting of long acting reversible contraception (LARC) and screening services for sexually transmitted infections. There is also a vasectomy service (male sterilisation) provided at the centre. MSI West London Centre also manages five early medical unit (EMU) satellite clinics located in the community, where early medical abortion and consultations in the early stages of pregnancy are provided in a private consultation room.

We inspected this service using our comprehensive inspection methodology. We carried out unannounced inspections on 21 and 22 of May 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.

At our previous inspection on 6 and 7 July 2017 we found a breach in regulation and we served a requirement notice in respect of:

Regulation 12 Health and Social Care Act (Regulated Activities) Regulations 2014 Safe care and treatment.

At this inspection we checked that action had been implemented to address this breach and we found that improvements had been made.

Services we rate:

We rated this service as good overall. We found good practice in relation to:

• The service had enough staff to care for patients and keep them safe. Staff had training in key skills, understood how to protect patients from abuse, and managed safety well. Staff assessed risks to patients, acted on them and kept good care records. The service managed safety incidents well and learned lessons from them. Staff collected safety information and used it to improve the service.

• Staff provided good care and treatment and gave patients pain relief when they needed it. Managers monitored the effectiveness of the service and made sure staff were competent.

• Staff treated patients with compassion and kindness, respected their privacy and dignity and took account of their individual needs. They provided emotional support to patients.

• The service planned care to meet the needs of local people and made it easy for people to give feedback. People could access the service when they needed it and did not have to wait too long for treatment.

• 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 patients receiving care. Staff were clear about their roles and accountabilities. The service engaged well with patients to plan and manage services and all staff were committed to improving services continually.

  However:

• Hand hygiene compliance rates were low and we observed isolated occasions where staff did not wash their hands after touching computer keyboards when treating a patient.

• There was no record of stock levels for medicines such as mifepristone and misoprostol which meant the service was not following the provider’s medicines management policy and it would not be possible to check if there were discrepancies in stock levels.

Following this inspection, we told the provider that it should make some improvements, even though a regulation had not been breached, to help the service improve. Details are at the end of the report.

Nigel Acheson

Deputy Chief Inspector of Hospitals

Updated 1 August 2019

Marie Stopes International West London Centre provides surgical termination of pregnancy up to 23 weeks and six days gestation and medical termination of pregnancy up to nine weeks and six days gestation. The centre also has five satellite clinics in the community providing medical termination up to nine weeks and three days gestation. The service also provides contraception advice including the fitting of long acting reversible contraception (LARC) as well as vasectomy (male sterilisation services.

We rated this service as good overall.

Safe, effective, caring, responsive and well led were rated as good.