Last week, SPUC reported that three BPAS abortion clinics in the North of England were put into special measures after being given damning safety reports by the Care Quality Commission (CQC).

Now, it emerges that another abortion clinic, this time a private provider in London, has also been put into special measures, again with concerns over patient safety.

The Gynae Clinic, a small independent service in central London, was rated “inadequate” for safety and governance, and was given the same rating overall following a CQC inspection. Inspectors also served a Warning Notice “under section 29 of the Health and Social Care Act 2008. This was served for failing to comply with Regulation 12: Safe Care and Treatment, and Regulation 17: Good Governance.” Professor Ted Baker, Chief Inspector of Hospitals, said that if the provider made insufficient improvements in the next six months, “we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service.”

Pills by post safety concerns

Unlike the BPAS clinics, the primary safety concerns were around pills by post, the dangerous practise of sending women abortion drugs in the post following a telephone consultation.

An action the service was told it “MUST take to improve” to avoid closure was “ensure that medicines, in particular pills by post, are labelled safely and in accordance with the Human Medicines Regulations 2012, so that service users are been able to correctly identify the medicines and know when to self- administer them.”

The full reason for this warning was given further down the inspection report:

“Medicines in the pills by post box were not labelled safely. We saw one example where the medicine mifepristone, 200mg tablet, was to be posted to a woman on the same day. The tablet was in an unlabelled, sealed, clear plastic bag, which in turn was in a paper bag, with the medicine's name, service user's name and date of birth on it. However, the label did not have the “keep out of sight and reach of children”, directions or the cautionary and advisory labels. As a result, the service user may not have been able to take the medicines as prescribed or store the medicine safely. We saw abortifacient medication foils (mifepristone and misoprostol) had been cut so that women were only issued a certain number of tablets. These two medicines were not dispensed separately with complete individual labels. This meant that service users could be at risk of not taking the medicines as prescribed.”

No follow up contact with patients

The inspectors also echoed concerns often raised by SPUC about the pills by post policy around women taking the pills later in pregnancy, and complications not being recorded. The report said:

“The service had introduced telemedicine consultations in response to the COVID 19 pandemic. This allowed women to have remote consultations and those who were suitable for early medical abortions could have their medicines sent to them. However, the service did not have any follow up contact with these women after their early medical abortion. This meant that the service did not know if women had taken the medication, or if they had any complications from the termination. Also, the service did not know if the women had taken the medication before the legal gestation time of 9 weeks and 6 days, meaning women could terminate the pregnancy later than the legal gestation limit, which could put them at risk of complications.”

Other issues raised by the CQC report included staff not having proper safeguarding training, not using correct risk assessment procedures, and bad leadership.

A disservice to women

Alithea Williams, Public Policy Manager at SPUC, said: “The level of care women are receiving at this ‘clinic’ is appalling. Abortion providers tell us to trust women – apparently that means sending them drugs in a sandwich bag without proper instructions on how to use them. Then they don’t even bother to check up on these women to see if there’s been any complications, or if the legal requirements have been met, or even just to check they’re ok. Official inspectors are now picking up on problems with the pills by post policy that we’ve been pointing out since the beginning. It’s high time that the Government listened and ended it immediately.”