Termination of pregnancy services were safe, caring, effective, responsive and well led.

Staff followed best practice in cleanliness and infection control. Staff reported incidents and risks. The service had clear and effective systems for managing complaints and shared lessons learned throughout the service and the wider organisation. Managers made sure that they notified staff about lessons learned from incidents and complaints and any resulting actions. Staff knew about procedures to follow in the case of a major incident.

Nursing and medical staffing was sufficient and appropriate to meet the needs of clients in their care. Staff were trained and assessed as competent for general nursing practice. All nursing staff completed formal training and competency assessments.

Staff ensured medicines were stored and prescribed safely. Doctors prescribed pain relief.  Clients were provided with pain relief before treatment and advised about pain relief following abortion treatment. However, medical abortion records did not always show clearly why staff did not administer some prescribed medications.

Medical records were legible and assessments were completed consistently, with associated discharge plans and dates. Medical records were complete and staff obtained written consent from all clients.

The service had processes for implementing and monitoring the use of evidence-based guidelines and standards to meet clients’ care needs. Staff monitored clients at all stages of their treatment.

Staff told us how they involved and treated women with compassion, kindness, dignity, and respect. We observed interactions between clients and staff in the public areas of the service. The results of the BPAS Client Satisfaction reports showed that 98% of clients at BPAS Newcastle upon Tyne were ‘extremely likely’ or ‘likely’ to recommend the service to family and friends.

All clients had checks and tests before procedures. Waiting times for appointments were consistently within the guidelines set by the Department of Health, unless clients chose appointment times outside the recommended timescale. Information and advice were available from staff, leaflets and on-line to women at all stages of their care. There were appropriate processes in place should a woman wish the clinic to dispose of the pregnancy remains sensitively. Staff offered women testing for sexually transmitted infections before any treatment. The service could provide interpreting and counselling services to women if necessary. The service was accessible for clients with disabilities

Senior managers had a clear vision and strategy for this service. There was strong local leadership of the service with quality care and client experience seen as the responsibility of all staff.

Staff felt proud of the service they gave and felt that they met the requirements of Department of Health (DH) Required Standard Operating Procedures and Royal College of Gynaecologists Clinical Guidelines. They felt supported to carry out their roles and had confidence to raise concerns with managers.

We saw people who used the service were involved in the planning of their treatment and were given information to help inform their decisions. The staff told us when people wanted treatment, they were presented with the options available to them.

We spoke with a patient on the day of our visit. They were positive about the way they had been treated. For example, the patient described the service as "confidential" and "helpful". The patient said staff had treated them with respect and provided support and explained the process.

Staff received training and support to deliver care and treatment safely to patients. A staff member said BPAS was "a fantastic employer". They also said there were "excellent training opportunities".

The provider regularly monitored the service to make sure that risks to patient safety were minimised and an appropriate standard of care and treatment was provided.

We did not speak to people who used this service as part of this review. We looked at a random sample of medical records. This was to check that current practice ensured that no treatment for the termination of pregnancy was commenced unless two certificated opinions from doctors had been obtained.

At the time of the visit no patients were available to talk with on the premises.

We saw that people who had used the service had said they were “…very satisfied with the cleanliness, comfort and standard of care given” at the clinic. They said that clinic had made them feel “…welcome, given good advice and involved the person who came with them.”

Further, it was commented they could not find fault with the service and “…nothing could be improved” and would give the service “…ten out of ten!”

We observed people waiting for their appointments and saw they were reassured beforehand by staff in a friendly manner, in appropriate surroundings and a comfortable environment.

We checked client records and saw before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. We confirmed staff received training and support to deliver care and treatment safely to patients.

There were systems in place to identify, assess and manage risks to the health, safety and welfare of people used the service and others.

We saw there were information leaflets at the reception area and throughout the premises that encouraged people who used the service to make complaints, suggestions or concerns known.