Archived: Marie Stopes International Central London Centre

Updated 12 October 2017

Termination of Pregnancy (ToP) refers to the termination of pregnancy by surgical or medical methods. Marie Stopes International (MSI) Central London is part of the provider group MSI UK and MSI International, a not for profit organisation that was founded in 1976 to provide a safe, legal abortion service following the Abortion Act 1967.

MSI Central London was registered with the Care Quality Commission (CQC) in October 2010. Regulated services are provided at Whitfield Street, Central London and at three early medical units (EMUs), known as satellite clinics: Watford, Hemel Hempstead, and The Whittington Hospital in London. Services include: early medical abortion (EMA) up to 9 weeks and 3 days, surgical termination of pregnancy (ToP) without anaesthesia or with sedation anaesthesia up to 11 weeks and 6 days, consultations, ultrasound scans, counselling and support, family planning and advice on contraceptive options, and contraception. In addition, vasectomy (male sterilisation) performed under local anaesthetic, well woman screening, well man screening, and sexually transmitted infection testing and screening are also provided.

All four locations hold a licence from the Department of Health (DH) to undertake termination of pregnancy services in accordance with the Abortion Act 1967. Services are provided predominantly to NHS-funded patients referred by local clinical commissioning groups, as well as to private patients for health screening.

From May 2016 to April 2017, MSI Central London carried out 1811 surgical termination of pregnancy procedures and 1404 early medical abortions. There were 269 vasectomy procedures performed within the same period.

We carried out an announced comprehensive inspection on 4 and 5 July 2017 at MSI Whitfield Street and an unannounced inspection at MSI North London Centre Whittington on 14 July 2017. We have not provided ratings for this service. CQC does not currently have a legal duty to award ratings for those services that provide solely or mainly termination of pregnancy services; amendment to the current Care Quality Commission (Reviews and Performance Assessment) Regulations 2014 is required to enable us to do this.

We observed staff interaction with paients and made checks on the environment and equipment. Before and after our visit we reviewed performance information submitted by the provider. We spoke with staff including: medical staff, registered nurses, health care support workers, administrative staff, and managers. We also spoke with six patients. We reviewed 50 ‘tell us about your care’ comment cards which patients had completed prior to our inspection. During our on-site visits, we reviewed 23 sets of patients' records, including 13 patients who used the termination of pregnancy services and ten who underwent vasectomy.

There were no special reviews or ongoing investigations of the service by the CQC at any time during the 12 months before this inspection. The service was inspected in 2014 and 2016. The most recent inspection took place in April 2016 where we identified a number of areas for improvement in the domains of safe, effective, caring and well-led. We took enforcement action for breaches of the following regulations: Regulation 12 Care and treatment must be provided in a safe way for service users; Regulation 17 Systems or processes must be established and operated effectively to ensure compliance with the requirements in this part.

These regulatory breaches were also found at an inspection of the governance systems at the MSI corporate (provider) level in July and August 2016.

Updated 12 October 2017

Marie Stopes International (MSI) Central London is part of the provider group Marie Stopes International, a not for profit organisation that provides termination of pregnancy service.

MSI Central London was registered with the Care Quality Commission (CQC) in October 2010.

Regulated services are provided at Whitfield Street, Central London and at three early medical units (EMUs), known as satellite clinics: Watford, Hemel Hempstead, and The Whittington Hospital in London.

Services include: early medical abortion (EMA) up to 9 weeks and 3 days, surgical termination of pregnancy (ToP) without anaesthesia or with sedation anaesthesia up to 11 weeks and 6 days, consultations, ultrasound scans, counselling and support, family planning and advice on contraceptive options, and contraception. In addition, vasectomy (male sterilisation) performed under local anaesthetic, well woman screening, well man screening, and sexually transmitted infection testing and screening are also provided.

The organisation provides services to adults and young people above the age of 15. 

We had previously inspected MSI Central London in April 2016 when we highlighted numerous concerns. This inspection was carried out to follow up on any previously raised concerns and to assess any improvements made by the provider.

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 questions. However, we have not provided a rating for this service.

We regulate termination of pregnancy services, but CQC does not currently have a legal duty to award ratings for those services that provide solely or mainly termination of pregnancy (ToP) services. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

Since our last inspection in 2016, we have noted the following improvements at MSI Central London: a new system for incident reporting, improvements to the environment, replacing carpets with washable flooring, the implementation and monitoring of surgical safety checklists, the management of early warning scores in deteriorating patients, improved clinical governance and monitoring of patient outcomes, risks and complaints, and improved communication with locality managers and the MSI executive management team.

We told the provider MUST take following actions to meet the regulations:

• The provider must ensure fire safety checks and evacuations are carried out.
• The provider must ensure there are processes in place to ensure that equipment is serviced and maintained in line with manufacturer’s guidance for both clinical and non-clinical equipment.

We also said the provider SHOULD:

• Carry out and act upon investigation and analysis of staff satisfaction.
• Ensure patient feedback is consistently obtained and used to improve the service.
• Enable all staff to complete training that is necessary for them to fulfil their role(s), including mandatory training and relevant skills training.
• Ensure there are arrangements to monitor and reconcile the stock of medicines.
• Ensure patients' privacy is respected at all times including when they are in the waiting area and recovery lounge. 
• Ensure all staff, including medical staff, are appraised regularly and suitable records of revalidation and appraisal are kept.

Professor Edward Baker

Chief Inspector of Hospitals