National Unplanned Pregnancy Advisory Service Stoke

Updated 24 October 2019

The National Unplanned Pregnancy Advisory Service Stoke (NUPAS) opened in 2004 and began offering early medical abortions in 2009. The service stopped doing surgical, manual vacuum aspirations in October 2018. The service provides abortion information and consultation, early medical abortion up to 63 days, free pregnancy testing and contraceptive advice. At the time of the inspection the service was not funded to undertake sexually transmitted infection screening. However, leaders told us that all patients are signposted to local sexual health services for screening and that high-risk patients were encouraged to have screening if they were proceeding to surgical interventions.

At the time of the inspection there was a registered manager in post.

We have inspected this service three times, in 2012, 2013 and 2017. The service was not previously rated.

National Unplanned Pregnancy Advisory Service Stoke is operated by National Unplanned Pregnancy Advisory Service Limited; it is in Newcastle Under Lyme, Staffordshire. The service primarily serves the communities of Stoke and North Staffordshire. It also accepts some patient referrals from outside this area.

At the time of the inspection there were no surgical lists undertaken at the service in Stoke on Trent. Any patients needing a surgical procedure were referred out to the Manchester clinic.

Updated 24 October 2019

National Unplanned Pregnancy Advisory Service Stoke is operated by National Unplanned Pregnancy Advisory Service Limited. The service does not have overnight facilities. Facilities at the service include treatment, screening and consultation rooms, a waiting area and offices all which are located on the ground floor.

The service provides early medical abortions up to 63 days, medical abortion advice and treatment, surgical abortion advice, contraception and pregnancy testing. An early medical abortion involves taking medication to end a pregnancy, it doesn’t require surgery or anaesthetic and is more commonly known as the abortion pill. It involves taking two different types of pills at two different times. The service no longer provides manual vacuum aspirations.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced inspection on 19 June 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.

Services we rate

We rated it as Good overall.

We found the following areas of good practice:

• 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. The service-controlled infection risk well. Staff assessed risks to patients, acted on them and kept good care records. They managed medicines well. 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, gave patients enough to drink, and gave them 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 patients, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, took account of
• their individual needs, and helped them understand their conditions. They provided emotional support to patients, families and carers.
• The service planned care that took account of patients’ individual needs and 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 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, we also found the following issues that the service provider

• The service did not always meet their monthly target rates for some waiting times. This was identified by the service as being due to patient choice, bank holidays and a lack of sonographer.

• Effective systems were not in place to check emergency equipment and consumables were consistently safe for use.

• The provider did not provide staff with any specific training around patients with a learning disability.

• Two policies were not up to date as they were under review.

• The service did not keep an informal log of complaints to learn from them.

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

Deputy Chief Inspector of Hospitals

Nigel Acheson

Updated 24 October 2019

Termination of Pregnancy was the main activity of the clinic. We rated this service as good overall because it was good in safe, effective, caring, responsive and well led.