Abortion care

Quality statement

Healthcare commissioners and providers work together to make abortion services easy to access.

Rationale

Providing abortion services that are easy to access will help to improve women's experiences, enable earlier presentation and reduce delays and complications. It will help women to avoid stigma and negative attitudes when requesting an abortion and to maintain their privacy and confidentiality. Commissioners and providers should work together to remove barriers to accessing abortion services to meet the needs of the local population.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

What the quality statement means for different audiences

Service providers (such as NHS hospital trusts and independent abortion providers) work with commissioners to ensure that abortion services are easy to access. Service providers support initiatives to improve access. This includes making information about abortion services widely available, allowing self-referral (for example through an online booking system or drop-in service), considering telemedicine (providing assessments by phone or video call) and providing information about any upfront funding for travel and accommodation.

Health and social care practitioners (such as doctors, midwives, nurses and social workers) give women information on how to access abortion services. Health and social care practitioners do not allow their personal beliefs to delay access to abortion services.

Commissioners (clinical commissioning groups and NHS England) work with providers to ensure that abortion services are easy to access, including facilitating self-referral pathways. Commissioners identify the needs of the local population and work with providers to improve access for women with pregnancies at all gestational stages where abortion is legal. This includes making information about abortion services widely available, providing online booking systems and drop-in services that do not need referral from a healthcare professional, and considering telemedicine (providing assessments by phone or video call) and upfront funding for travel and accommodation.

Women who are considering an abortion can easily find out how to contact an abortion service and arrange a convenient first appointment.

Source guidance

Abortion care. NICE guideline NG140 (2019), recommendations 1.1.1, 1.1.2 and 1.1.9

Definitions of terms used in this quality statement

Equality and diversity considerations

Healthcare commissioners and providers should ensure that pregnant women who self-refer to an abortion provider and are eligible for the NHS Healthcare Travel Costs Scheme or upfront funding for travel and accommodation do not need a GP referral to access the funding.

Healthcare commissioners and providers should ensure that information about how to access abortion services is easily available to women in vulnerable groups. These include sex workers, women who are experiencing homelessness, women in prison and women who may find it difficult to access healthcare services because they are not registered with a GP.

Ensure that women experiencing homelessness can access online health and social care information and are supported to use online services, for example, by providing internet access at places where women experiencing homelessness spend time, such as day centres or hostels (for more information, see NICE's guideline on integrated health and social care for people experiencing homelessness, recommendation 1.5.8).

Women should be provided with information that they can easily read and understand themselves, or with support. Information should be in a format that suits their needs and preferences, for example video or written information. It should be accessible to women who do not speak or read English, and it should be culturally and age appropriate. Women should have access to an interpreter or advocate if needed. For women with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard.

Providing assessments by phone or video call can be particularly beneficial for women living in remote areas; women experiencing domestic violence, abuse or coercion from their partner or family; and women experiencing cultural barriers to accessing abortion services. Providers should, however, ensure that safeguarding procedures are in place for all women, including those accessing the service remotely. Providing a choice of assessment by phone, video call or face to face ensures that women can access abortion services in the way that best suits their personal circumstances.