BPAS - Middlesbrough

Updated 21 June 2022

BPAS Middlesbrough is operated by British Pregnancy Advisory Service. The British Pregnancy Advisory Service was established as a registered charity in 1968 to provide a safe, legal abortion service following the 1967 Abortion Act. BPAS Middlesbrough opened in 2012.

The BPAS Middlesbrough clinic undertakes; early medical abortion up to ten weeks (EMA) and surgical termination of pregnancy (SToP) up to 13 weeks and six days, with local anaesthetic and conscious sedation. BPAS Middlesbrough did not provide general anaesthetic (GA). Women requiring later surgical abortions were signposted to BPAS Units at Doncaster, Merseyside or Richmond. The clinic also offered contraception and sexually transmitted infection testing as part of the termination of pregnancy treatment.

The location is registered to provide the following regulated activities:

• Termination of pregnancies

• Surgical procedures

• Treatment of disease, disorder or injury

• Family planning

• Diagnostic and screening procedures

The location has a manager registered with CQC.

BPAS Middlesbrough clinic was last inspected 4 August 2021 following information highlighted at routine engagement with another BPAS location on 15 June 2021. Following the last inspection, we took enforcement action which included the use of our urgent enforcement powers, where we placed conditions on the location’s registration in relation to safe care and treatment, consent and safeguarding.

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

Updated 21 June 2022

This was a comprehensive, unannounced inspection to follow up on enforcement action taken during an inspection in August 2021 where we identified specific areas of concern.

We rated the service requires improvement overall because:

• The service did not have enough staff to offer cover arrangements in the event of staff absence potentially delaying treatment times for women.
• The service did not label medicines appropriately in line with legal requirements.
• Although leaders had begun to operate effective governance processes throughout the service and used systems to manage performance effectively, these were new processes and had not had time to become embedded in practice or show consistent improvements.
• The service did not have a system for the observation of children under the age of 18 years using the modified early warning score (MEWS) to ensure early recognition and safe timely escalation of a deteriorating children.
• The service did not have a process in place to measure wait times between contact to consultation or consultation to treatment, meaning that they were not able to monitor or improve waiting times for women

However:

• The service had improved its processes and systems to safeguard people from abuse and manage patient safety incidents. Staff now comprehensively assessed and documented risk assessments.
• Staff had training in key skills, they received training on how to recognise and report abuse. The service-controlled infection risk well. Staff kept clear and up to date records of patients care and treatment.
• Staff provided good care and treatment, gave women refreshments, 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 women, advised them on how to lead healthier lives, supported them to make decisions about their care, and had access to good information.
• Staff supported patients to make informed decisions about their care and treatment. They followed national guidance to gain patients’ consent. Staff now recognised and assessed a patient’s possible lack of mental capacity to make decisions and documented this.
• 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.
• The service planned care to meet the needs of local people, took account of women’s individual needs, and made it easy for people to give feedback.
• Leaders ran services well using reliable 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.

Updated 21 June 2022

Our rating of this service improved. We rated it as requires improvement.

See overall summary for more information.

In the reporting period 1 January 2022 to 27 April 2022, the centre carried out 904 surgical terminations of pregnancy (SToP) under local anaesthetic/conscious sedation, 355 early medical abortions. The centre held a current Department of Health licence to practice under the Abortion Act and displayed copies of the licence at each of its registered locations.

• Zero patients were transferred out to another hospital from January 2022 to April 2022.
• No incidences of hospital acquired Methicillin-resistant Staphylococcus aureus (MRSA), Methicillin- susceptible Staphylococcus aureus (MSSA), Escherichia coli (E.coli) or Clostridium botulinum (C.diff).
• One complaint was received within the reporting period from September 2021 to March 2022.