"Serious concerns" were raised about patient safety at the UK's leading abortion provider, according to a report by independent health regulators.
The Care Quality Commission (CQC) highlighted issues around staff training and risk assessment at Marie Stopes International (MSI) clinics in the UK, while some staff positions providing clinical oversight went unfilled.
Four formal warnings for regulatory breaches around consent, safeguarding, care and treatment, and governance were issued by CQC, leading to the temporary suspension of some services between August and October this year.
This included the suspension of terminations for under-18s and vulnerable groups of women and surgical terminations under general anaesthetic or conscious sedation. All surgical terminations were halted at Marie Stopes' Norwich clinic.
Around 70,000 abortions are performed at Marie Stopes clinics every year, most of which are carried out on behalf of the NHS. During the suspension period, plans were put in place to redirect patients to clinics belonging to the British Pregnancy Advisory Service and NHS trusts.
The report also found that staff were insufficiently trained in resuscitation procedures and that competency checking on anaesthetists, doctors, and staff was carried out ad-hoc.
There were also shortfalls in training for staff to explore issues such as female genital mutilation and child sexual exploitation in younger patients, as well as a lack of training in how to support vulnerable patients in general.
In one case, the report found a woman with learning difficulties had not fully understood the procedure.
Suzanne Ash, interim managing director of MSI, acknowledged the CQC's concerns and said significant improvements had been made to the clinic's services.
"We have worked hard with the Care Quality Commission to regain compliance and we’re grateful to them for their assistance," Ash said.
"Since the inspections, we’ve made considerable changes to our management, governance, and assurance processes, including extensive training of staff, and updating of policies," she continued. "We have learned from this, and intend to continue our focus on providing the safe and compassionate care that women expect and deserve."
During the inspection period, Professor Edward Baker, deputy chief inspector of hospitals at the CQC, said, it received positive feedback about care patients had received on an individual basis, but it had serious concerns over the way the organisation was run overall.
"On the ground, we found that feedback from patients was positive across Marie Stopes International's centres and its staff provided a nonjudgmental service and treated patients with dignity and respect," Baker said.
"However, our concerns at a corporate level – particularly around governance arrangements, staff training, and around patient safety and safeguarding protocols – did not give us the necessary assurance that patients would be protected from avoidable harm at all times, that possible safeguarding concerns could be identified, and that incidents could be reported and learned from."
Baker praised MSI for improvements that had been made since the inspections, and said the CQC will continue to monitor its services closely.
He added: "We will not hesitate to take further action, if necessary in order to guarantee this provider meets the standard of care we expect and that its patients deserve."