MSI Reproductive Choices Regional Treatment Centre - Manchester

Updated 17 November 2022

MSI Reproductive Choices Regional Treatment Centre – Manchester is operated by MSI Reproductive Choices. The treatment centre is a dedicated standalone building retrofitted for clinical care, including surgical procedures. The treatment centre has three consulting rooms, eight day case beds, a surgical theatre suite, a recovery unit with five chairs, outpatient facilities and ultrasound facilities.

The service provides surgical termination of pregnancy up to 23 weeks and six days gestation and early medication abortion and medical termination of pregnancy up to nine weeks and six days gestation. Surgical procedures are available with a range of sedation options, including general anaesthesia. The service provides consultations, ultrasound scans, contraception, sexual health screening, and vasectomy procedures.

The treatment centre provides the full range of care services and is the registered location. The service offers early medication abortion, consultations, and ultrasound scan services from 10 satellite clinics across the region. Located across the north west, the satellite sites operate from rented clinical spaces in primary care centres.

There are two registered managers in post. One individual is the operations manager and is responsible for the operational aspects of the service and one individual is a clinical matron and leads clinical provision. Both managers share responsibility for the regulated activities.

The service is registered to provide the following regulated activities:

• Treatment of disease, disorder or injury
• Surgical procedures
• Diagnostic and screening procedures
• Termination of pregnancies
• Family planning

In our report we refer to OneCall and RightCare. These are centralised teams within the provider that deliver support and care to patients as part of integrated pathways.

We last inspected the service in August 2018. At that inspection we rated the service good overall and good in each domain except for well-led, which we rated requires improvement. This reflected a need for more embedded governance processes, including around manager access to staff employment records and improvement medicine storage management. At this inspection we found staff had addressed these previous concerns and implemented a wide range of initiatives to improve and sustain care.

Updated 17 November 2022

Our rating of this location improved. We rated it as outstanding because:

• The service had enough staff to care for patients and keep them safe. Staff had extensive, specialist 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 provided consistently good care and treatment that exceeded expectations. There was a strong safeguarding culture that was multidisciplinary in nature and staff demonstrated a rapid response to providing care for people at significant risk of harm and abuse.
• Managers monitored the effectiveness of the service through a programme of continual, ambitious auditing and effective benchmarking. They made sure staff were competent by providing an extensive programme of continual professional development that was based on the latest understanding of patients’ health needs.
• Staff worked well together for the benefit of patients and established a wide range of multidisciplinary relationships to explore opportunities for improved care. Staff advised patients on how to lead healthier lives based on deep knowledge of their personal circumstances, supported them to make decisions about their care, and had access to good information.
• Key services were available seven days a week and staff sought an expansion of some services where this would improve patient outcomes, including in rapid response to significant increases in demand from specific patient groups.
• 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 and worked collaboratively with specialist support services to meet cultural and other personal needs.
• The service planned care to meet the needs of individuals and populations groups across the region and made it easy for people to give feedback. People could access the service when they needed it and the service maintained a highly responsive approach to maintaining short waiting times.
• Leaders ran services well using reliable information systems and supported staff to develop their skills through a programme of engagement that challenged each person with stretch goals. Staff understood the service’s vision and values, applied them in their work, and used provider standards to challenge the status quo and stigma that impacted people’s lives.
• Staff felt respected, supported and valued. They were focused on the needs of patients receiving care and creating a working environment that promoted innovation and development. Staff were clear about their roles and accountabilities. The service engaged meaningfully with patients and the community to plan and manage services and all staff were committed to improving services through research and exploration of new evidence-based practice.

However:

• There were gaps in facilities management safety processes in the satellite clinics we included in our clinical site inspections. This included a lack of emergency equipment and security arrangements in one clinic and poor understanding of the nature of the service by third party reception staff in another.
• There was room for improvement in fire safety standards in the main treatment centre.

Updated 17 November 2022

We rated this service as outstanding because it was safe, effective, caring, responsive, and well led and demonstrated a wide range of innovation. Please refer to our main summary.