BPAS - Stratford upon Avon

Updated 29 June 2022

The BPAS Stratford Upon Avon hub (Stratford Upon Avon, Coventry and Nuneaton services) offer consultation, medical assessment, early medical abortion up to nine weeks and six days and service specific counselling and treatment. As part of the care pathway, women are offered sexual health screening and contraception.

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.
• Abortion Aftercare.
• Sexually Transmitted Infection (STI) testing and treatment.
• Contraceptive advice and supply.

BPAS Stratford Upon Avon is registered to provide surgical termination of pregnancy but this activity has been suspended by the provider since the beginning of the Covid 19 pandemic. There are no current plans to recommence this registered activity. Women who are over nine weeks and six days or require a surgical termination of pregnancy are offered appointments at another BPAS termination of pregnancy service.

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 On 30 March 2020, the Secretary of State for Health and Social Care made two temporary measures that superseded this previous approval.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 June 2019. The current registered manager had been registered since October 2021 and is also the registered manager of another BPAS registered location.

Updated 29 June 2022

British Pregnancy Advisory Service (BPAS) Stratford Upon Avon is operated by British Pregnancy Advisory Service and was inspected as part of CQC’s comprehensive inspection programme. BPAS Stratford Upon Avon has not been inspected since it was registered in June 2019. BPAS Stratford Upon Avon has two satellite services in Coventry and Nuneaton and is called the ‘Stratford Upon Avon hub’. The BPAS Stratford Upon Avon hub provide termination of pregnancy services for women in Stratford Upon Avon, Coventry and Nuneaton and the surrounding areas.

From 1 April 2021 to 31 March 2022, the Stratford Upon Avon hub completed a total of 1896 early medical abortions (less than nine weeks six days pregnant). Of this total 799 were completed at the Stratford Unit Avon, 688 at Coventry and 409 at Nuneaton.

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

We rated this location it as requires improvement because:

• Women did not have timely appointments and had to wait longer than national guidance and there could be a delay in women receiving treatment.
• Requirements of the duty of candour were not fully met.
• Not all medicines were stored appropriately.
• Timely statutory notifications were not always made to The Care Quality Commission

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. The service controlled infection risk well. Staff assessed risks to women, acted on them and kept good care records.
• Staff provided good care and treatment and there were appropriate arrangements to ensure women had appropriate pain relief. 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, and helped them understand their conditions. They provided emotional support to women, families and carers.
• The service made it easy for people to give feedback.
• Leaders ran services using 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 and the community to plan and manage services and all staff were committed to improving services continually.

Updated 29 June 2022

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