Care Quality Commission
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Findings of termination of pregnancy inspections published

CQC yesterday publishes 249 individual inspection reports into providers offering termination of pregnancy services.

The Abortion Act 1967 requires a form (HSA1) certifying that the requirements for a termination have been met to be signed by two doctors before the procedure takes place.

In January, CQC identified evidence during an inspection of a private clinic that HSA1 forms were being pre-signed by one doctor. This is in breach of the Abortion Act, and allows the second doctor to take a solo decision to allow a termination.

The Secretary of State for Health then asked CQC to investigate whether this practice was widespread. The resulting inspection programme, which took place in less than two weeks in March, looked specifically for evidence of pre-signed HSA1 forms. The inspections followed a letter from the Chief Medical Officer in February to all providers of termination of pregnancy services making clear their responsibilities under the Abortion Act.

As a result of these unannounced inspections, CQC identified clear evidence of pre-signing at 14 locations, all of which were NHS Trusts.

Inspectors also found irregularities with the consistency and completeness of HSA1 forms (i.e. ‘place of assessment’ not completed) at a number of other providers where no evidence of pre-signing was identified. In these cases, CQC highlighted issues to providers but did not take further action.

CQC required the Trusts who were found to be pre-signing HSA1 forms to stop this practice in order to comply with the Abortion Act. All have now done so, and steps including internal audits and staff training have been taken to ensure continued compliance.

These 14 NHS Trusts are listed below. CQC did not find any evidence that any women had poor outcomes of care at any of these locations.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England. We make sure that care in hospitals, dental practices, ambulances, care homes, people’s own homes and elsewhere meets government standards of quality and safety – the standards anyone should expect whenever or wherever they receive care. We also protect the interests of vulnerable people, including those whose rights are restricted under the Mental Health Act.

We register services if they meet government standards, we make unannounced inspections of services – both on a regular basis and in response to concerns – and we carry out investigations into why care fails to improve. We continually monitor information from our inspections, from information we collect nationally and locally, and from the public, local groups, care workers and whistleblowers. We put the views, experiences, health and wellbeing of people who use services at the centre of our work and we have a range of powers we can use to take action if people are getting poor care.


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