UNISON is celebrating a team of nurses who ensured that, throughout the pandemic, women have still been able to access abortion services.
Every year, the union sponsors the Team of the Year award at the Nursing Times awards. This year, that has been won by MSI Reproductive Choices UK, which made sure tha women had access to virtual support and medicines for early abortion during the pandemic.
The award to the team is in recognition of its rapid development of a treatment pathway to make sure women could still access early medical abortion.
Before the pandemic, such abortions were delivered in a two-stage treatment in clinic or hospital, or with the first stage in a clinic and the second at home. Early in lockdown, balancing the need to provide abortions with curbing the spread of the virus, the government announced that both stages of treatment could be taken at home, with service provided by what is known as telemedicine.
Putting this into practice “took us six days,” says Nicola Moore, the executive director of quality and governance at MSI UK.
“On 30 March, the English government announced temporary approval of home use of both stages of early medical abortions. As soon as the approval was announced, we got into formation. By 6 April, we’d developed a treatment pathway that we were ready to launch.”
Setting up a streamlined process
MSI UK set up a streamlined process for administering telemedicine. Patients who contact MSI Reproductive Choices are screened using safeguarding and clinical eligibility questions, then booked for an in-depth telephone consultation with a nurse.
After giving consent, patients then have the choice to receive their medication through the post or by collecting it from one of over 60 MSI UK clinics across England. All patients then have access to support from a 24-hour aftercare line and online information.
Ms Moore described how teamwork got the job done: “I thought I was something that would be delivered over a few weeks. Once we got going and identified all areas, the absolutely incredible passion and motivation from the team just got the job done. Everyone said ‘I’ll do this, I’ll do that,’ and it all fell into place.
“We’d really worked to finesse our operational performance beforehand, and we superimposed the whole model over our existing structure. We already have gold-standard safeguarding, and we were able to implement this new model swiftly.”
Betty Njuguna, director of nursing at MSI UK, described how the new process centred patient care: “We could discuss their needs and requirements before and just send the tablets to their home.
“Our pace was driven by the need to ensure that women had timely access to high-quality care that meets all standards of safety, in a way that supported national initiatives of lockdown.”
“I’m incredibly proud of the work we’re doing”
She went on to explain how the groundwork for these team dynamics was laid long before the pandemic. “We do value-based recruitment, so we only employ women who are pro-choice and who are committed to supporting women. Anyone working for us is working for us because they want to be here. I’m incredibly proud of the work we’re doing.
Ms Moore agreed: “It was evident from the outset that the team who delivered this were mission driven, without exception. We didn’t have to follow up on one person, because everyone did what was needed. Every day I’d say ‘I’m so proud to be working here’.
Ms Njuguna noted: “Winning this award is a significant step in destigmatising abortion care. We do this job out of love and care, and our teams are highly skilled. We streamlined our services to make sure that nobody is stuck at home with an unwanted pregnancy, not knowing what to do.
“For us to be acknowledged for the work we’re doing feels amazing.”
Ms Moore added: “Sixty-seven thousand women a year use our services. Abortion is a decision that nobody sees themselves making. Women do know what they want and need support to do something in their best interests.”
An MSI UK survey of patients found that, overall, 98.2% rated their experience as good or very good. Patients reported high confidence in telemedicine early medical abortion and high satisfaction with the convenience, privacy and ease of managing their abortion at home. 80% of patients reported preferring the telemedicine pathway to in-clinic treatment.
One anonymous patient said: “It was really nice to have that choice – as women, we should have the right to make our own choices, and it’s harder to talk face-to-face than over the phone.”
As lockdown eases once again, the team hopes that the telemedicine process will become permanent. Ms Njuguna says: “Since this has been brought in, the rate of EMA has risen from 72% to 80% of all abortions. This is good news, because it’s much safer to have a medical abortion. Why would you want to reverse something that’s working really well?”
Ms Moore adds: “I hope telemedicine is made permanent. It’s made it possible for so many women to access us, especially women who couldn’t travel to our centres anyway. The fact we’re now able to reach out to people in their own homes to support everything we can fills us with pride and joy.”
“We were so impressed by the teamwork at MSI”
UNISON national officer for nursing Stuart Tuckwood said: “There were so many teams in health services that did incredible work this year through the COVID-19 pandemic – picking one out for the award was very difficult.
“We were so impressed by the teamwork and achievements of the team at MSI UK. There were many really worrying consequences of the national restrictions for people’s health and their access to services. Women’s access to services to support them with reproductive choices and access to abortion could really have been badly affected.
“The team at MSI UK worked fast and in really innovative ways to make sure that wasn’t the case and that everyone women who needed them got a safe, high-quality response.
“We’re really proud to recognise their work and congratulate them on what they achieved by working as a team.’’
The award was presented in an online ceremony on 18 November 2020.