Background
Eight out of ten abortions in England and Wales take place in the Independent Sector by healthcare charities who receive contracts to provide care from the NHS. This arrangement works well for most patients and healthcare staff. However, around 3000 patients each year have more high support needs because of health or social reasons. They may require NHS hospital care from a range of specialists. Some patients may need to have a type of surgical abortion that few NHS hospital doctors are trained to do. This can mean delays for patients in getting their abortion.
Special funding had been approved to make sure abortion care for patients with high support needs can take place in their local area, but this is at different stages of set up across the country.
> To learn more about the project, please watch the introductory video below.
Aims and objectives
This study aimed to understand how high-quality abortion care can be provided to patients with high support health and/or social needs. It answered the following questions:
What are patients’ views and experiences of the abortion care they have received? How do these vary by different types of patients or settings?
What things do patients feel work well in how their care is provided from first contact with services to post-abortion? What things could be improved?
How is care for patients with high support needs who are having an abortion organised and monitored in different regions?
What things do health staff and other staff involved in care, such as social workers, feel affect how abortion care and support is provided to patients with high support needs?
Methods
The research was done in three areas in England at different stages in setting up care for patients with high-support health and/or social needs having abortions. We interviewed patients and professionals working in health, social and voluntary sectors on topics to answer our research questions.
Policy Relevance & Dissemination
Our work will help the planning of abortion care for patients with high support needs to make sure they can access services which suits their needs in a timely way. We will use different methods such as Blogs and conference presentations to make sure our findings reach both patients and professionals.
Video: Sarah’s story
The video below introduces our research project that is exploring how care is provided in England for patients requiring a referral to an NHS hospital for their abortion.
This video highlights that while independent abortion services provide 80% of abortions in England, about 3,000 patients each year require hospital-based care due to health or societal needs. The video shares Sarah’s story* (as a case study) to illustrate the challenges many patients face—such as long travel distances, costs, and delays—when accessing hospital abortion services. The project seeks to gather experiences from patients, healthcare providers, and support networks to inform recommendations for improving NHS abortion care in England.
*This case is fiction and does not address real patient cases. Our Patient and Public Involvement Team has also reviewed the video and provided input.
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