An abortion clinic in Streatham run by BPAS has been rated as "requires improvement" by the Care Quality Commission, and is the first abortion facility in the country to be ranked as "inadequate" on one criteria (leadership).

"This is the worst rating we’ve seen a clinic get," said Alithea Williams, Campaigns and Parliamentary assistant at SPUC. "This clinic, which is commissioned by the NHS to kill thousands of babies a year, cannot even get things like staff training and competency correct. It is unacceptable that women’s safety is being put at risk in this way."

Safe and caring?

When the CQC rates abortion clinics, it asks if they are they safe, effective, caring, responsive to people's needs and well-led. In its report, published 29 January 2020, the CQC said that the Streatham clinic required improvement on safety, effectiveness, and responsiveness, while "well-led" was rated as inadequate. Ratings were introduced in September 2017.

Among the issues highlighted in the report were:

• Staff who had not completed immediate life support training, sepsis training, or medicine management training
• Some staff had insufficient safeguarding training
• Not all equipment was in good working order or had been calibrated
• The service did not always manage patient safety incidents well. Staff did not always report incidents
• Patients were not offered the choice to take the second pill of a medical abortion in the clinic
• Local leaders did not always have the skills and abilities to run the service

Untrained staff

Much of the report focuses on personnel, saying that "the service did not always make sure staff were competent for their roles." It goes on: "We found one staff record where certain competencies for the role they were employed for had not been signed off since they started the organisation over three years ago."

The report is particularly damning about the clinic’s leadership, rating it as inadequate. It said that "local leaders did not always have the skills and abilities to run the service", and "staff did not always feel respected, supported and valued" and "risks were not always fully identified, and actions taken to reduce their impact".

Culture of blame and harassment

A negative culture was also reported by staff. The report says: "Most staff we spoke with, told us they felt the culture was reactive rather than proactive, with a culture of blame and harassment and this had created an unsupportive and demoralising environment at the centre."

Alithea Williams said: "It is not surprising that a clinic that kills thousands of unborn babies a year, especially one that specialises in late-term abortions, should prove a difficult place to work."

Choice?

Miss Williams also questioned the focus on the way in which home use of abortion pills is being handled by BPAS. The report states: "The clinic had recently started to offer to patients the home use of misoprostol. However, we found women were not offered the choice of returning to the clinic to take the second tablet if they wanted to."

This is the second time in months that a BPAS clinic has been rated as inadequate. A September report on the Merseyside clinic found a catalogue of safety abuses, and the CQC were actually contacted by the local NHS trust in March 2018, "who raised concerns regarding the frequency of patients coming to them from BPAS Merseyside."