MSI Reproductive Choices National Call Centre - One Call (Zeta House)

Updated 28 November 2017

MSI One Call is operated, commissioned and funded by Marie Stopes International. MSI clinics provide sexual health information, advice and treatments to approximately 100,000 patients each year. This includes approximately 70,000 termination of pregnancy treatments per year. This represents around a third of all terminations provided in England, the majority of which are for NHS patients. From the 30 June 2017 the Government agreed to pay the costs of consultation and termination of pregnancy fees for women from Northern Ireland.

MSI One Call is provided at Zeta House in Bristol. The service opened in 2000 and is the first point of contact for patients who are considering sexual health treatment through an MSI clinic. MSI One Call provides patient booking and patient support, including some test results for sexually transmitted infections for MSI services registered nationwide. This included: 12 main MSI clinics, 52 early medical units (satellite clinics linked to a main clinic) and 24 vasectomy services.

The service has had a registered manager in post since 2011.

The service had previously been inspected during August 2016. At this time the service was meeting all standards of quality and safety it was inspected against.

We inspected MSI One Call using our comprehensive inspection methodology. We reviewed data provided at other MSI services to inform this inspection.

Updated 28 November 2017

MSI One Call is operated by Marie Stopes International.

We inspected this service using our comprehensive inspection methodology. We carried out the unannounced on 7 September 2017.

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?

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

MSI One Call is the main contact centre for all MSI services in the UK. It provides the following: centralised patient booking, telephone consultation pre assessment, post procedure support and advice line and telephone counselling for patients attending any MSI clinics nationwide. MSI One Call is open 24 hours per day, seven days per weeks and is the first point of call for any patients wishing to access any of the clinic services provided at any MSI location.

We regulate termination of pregnancy services, but we do not currently have a legal duty to rate them when they are provided as a single specialty service. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary.

We found the following areas of outstanding practice:

• MSI One Call had an outstanding major incident plan. This included the provision of a duplicate call centre site, equipped to provide the most current IT systems required to keep the service running. The alternative site had the ability to be fully functional within two hours, minimising the impact on patient services.
• Patient feedback was sought continuously and analysis of this was completed by an independent, external provider. There was consistent, positive patient feedback that that MSI One Call provided an ‘exceptional’ service.
• MSI One Call facilitated and supported the provision of independent, qualified clinical counsellors for the benefit of the whole MSI service. The counsellors’ provided free, therapeutic therapy sessions to patients’ pre and post treatment. The amount of counselling was not limited but based solely on patient’s individual needs.

We found the following areas of good practice:

• The lead clinical staff for safeguarding vulnerable adults and children had advanced training, knowledge and experience and provided effective support to all staff at the call centre.
• There was a flexible staff work pattern which enabled the service to have sufficient staff at all times in response to changeable patient call numbers.
• Patients’ had their needs risk assessed by staff who understood what processes and policy they were required to follow.
• The building and working environment was secure and promoted patient privacy and staff safety and comfort.
• New staff completed a competency based training course at the start of employment. Systems were in place to provide ongoing staff training and support.
• There was evidence of effective team working and staff had a clear understanding of their own responsibilities and those of colleagues.
• Staff demonstrated a non-judgemental, kind and supportive approach to patients. Staff provided a patient led service; providing information, advice and support based solely in response to what patients called to enquire about.
• MSI One Call supported other MSI services to find interpreters to support with patient appointments.
• The centre was staffed and open 24 hours per day, seven days per week. Patients were offered a choice of treatment options at locations and times to suit them.
• Telephone counselling was offered to all patients who contacted any MSI service nationwide.
• There was a stable senior management team who had appropriate skills, qualifications and experience to provide effective leadership across the whole service.
• Senior staff had a clear understanding of quality and risk management issues related to the service. Action plans were documented and issues were kept under regular review.
• Processes were in place to obtain patient feedback and this was used to make service improvements.
• Staff were kept informed of local and national issues related to their roles. Staff reported a positive working culture and felt supported by senior staff

However, we also found the following issues that the service provider needs to improve:

• All staff should be supported to have in date mandatory training.
• All staff should be supported to have an annual appraisal.

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

Amanda Stanford

Interim Deputy Chief Inspector of Hospitals

Updated 28 November 2017

We regulate this service but we do not currently have a legal duty to rate when it is provided as an independent healthcare single speciality service. We highlight good practice and issues that service providers need to improve and take regulatory action as necessary. We have a duty to rate this service when it is provided as a core service in an independent hospital.