GREAT BRITAIN – Pills by Post
The change in regulation to enable BPAS to provide telemedical abortion to clients in the early stages of their pregnancy was essential during lockdown. Telemedicine provides accessible, safe, and effective abortion care, and enables us to support some of the most vulnerable clients who were previously unable to access in-clinic care. This regulatory change should be retained so that we can continue to provide this high standard of care in future.
While other healthcare services have been suspended or seen significant increases in waiting times over this period, access to abortion has been maintained and waiting times for abortion care have fallen significantly, with high levels of satisfaction. National data shows abortions are being provided earlier than ever before, with a record 86% of terminations performed before 10 weeks’ gestation in the first six months of 2020. This minimises the risk of complications and ensures that no woman has to remain pregnant longer than necessary.
Impact of Covid-19
- The COVID-19 outbreak has led to changes to clinical guidelines and licensed premises for Early Medical Abortion (EMA). In line with these changes, the most common form of abortion treatment currently available to women in Great Britain is telemedical EMA.
- There has been a rapid expansion in telephone and video call assessment, now accounting for 97% of consultations for abortion care.
Pills by Post
- BPAS’s telemedical EMA service, Pills by Post, was launched on 8th April to provide nurse- and midwife-led consultations over the telephone or video call, with medication posted to a woman’s home address where she was suitable for treatment.
- In the first quarter of telemedical provision, BPAS provided 16,910 Pills by Post treatments. This accounts for 80% of our total EMA caseload.
- The remainder of our clients having EMA attended a BPAS clinic for further checks including additional safeguarding, an ultrasound scan, or to ensure that they had the capacity to consent to treatment.
Impact on clients
- In a service evaluation conducted 14-21 days after treatment, 97% of clients said they were satisfied or very satisfied with their experience with BPAS.
- 80% of clients who expressed a preference would opt for having a telephone consultation and Pills by Post again if they needed another abortion in the future.
Impact on service
- In line with national figures, demand for abortion during COVID-19 peaked early in lockdown owing to delayed demand and pre-existing waiting lists. During April 2020, we provided 23% more abortions than in March 2020.
- In the first quarter of the Pills by Post service, the median national waiting time to treatment for an Early Medical Abortion was 2 days – a reduction of more than 50% on the same period last year.
- In the first quarter of the Pills by Post service, the median gestational age at treatment was 6 +2 weeks, compared to 7 +1 weeks for EMA clients in the same period in 2019.
FULL REPORT, September 2020
[Editor’s note: Well worth reading in full for the positive, women-centred picture it provides of this service and the high quality of care that can be achieved.]