BPAS - Richmond

Updated 1 September 2021

BPAS Richmond is operated by British Pregnancy Advisory Service. British Pregnancy Advisory Service (BPAS) Richmond provides a termination of pregnancy service in Richmond, Surrey. The service is provided from a building owned by the service. The service provides termination of pregnancy as a single speciality service. BPAS Richmond offers consultation, medical assessment, early medical abortion, medical termination of pregnancy and surgical termination of pregnancy up to 24 weeks gestation, counselling and treatment. As part of the care pathway, patients are offered sexual health screening and contraception. Surgical termination of pregnancy can be undertaken under local anaesthetic, general anaesthetic, conscious sedation and no 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 (up to 9 weeks and 6 days gestation)
• Medical termination of pregnancy (MToP)
• 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 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 On 30 March 2020 the Secretary of State for Health and Social Care made two temporary measures that superseded this previous approval.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 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 from their own home. i.e. rather than travelling into a clinic or hospital to work.

In the 12 months prior to our inspection the service completed 7693 abortions, of which 4003 were EMA by telemedicine (remote consultation and supply of abortifacient medication to take at home)

The service was last inspected in November 2015.There were areas of poor practice where the provider needed to make improvements. This included ensuring all staff understood and followed protocols for transferring women to NHS hospitals in the event of serious incidents, and complying with the practice recommended by the product manufacturer, NHS England and the Royal College of Anaesthetists, and discontinue multi-dosing from single patient use propofol ampoules.

During this inspection we found that these issues had been addressed.

Updated 1 September 2021

We had not previously rated this location. We rated it as good because:

• 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 eat and 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.
• Leaders ran services well 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.

However:

• The service did not always plan care to meet the needs of local people. People could not always access the service when they needed it and often had to wait too long for treatment. Waiting times were not in line with national standards.
• The service did not use a paediatric specific risk scoring tool for patients under the age of 16.

Updated 1 September 2021

We had not previously rated this location. We rated it as good because:

• 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 eat and 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.
• Leaders ran services well 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.

However:

• The service did not always plan care to meet the needs of local people. People could not always access the service when they needed it and often had to wait too long for treatment. Waiting times were not in line with national standards.
• The service did not use a paediatric specific risk scoring tool for patients under the age of 16.