NHS England has set out plans for improving access to abortion services as providers are experiencing rising levels of demand.
In a letter to ICBs, the commissioner said services are currently ‘under great pressure’ and that there is evidence that providers are not being funded adequately.
As a result of ‘significant service pressures’ providers have warned waits for surgical abortions are often three weeks or longer, despite NICE recommending patients should be assessed within a week of request and procedures completed within a week of assessment.
ICBs commission the majority of abortion services with charities delivering about 80% of care.
The letter, signed by NHSE’s chief delivery officer Steve Russell and national specialty advisor for gynaecology Professor Janice Rymer, warned that the pressures are affecting some of the most vulnerable patients.
These include ‘a small but important number of service users’ who will have experienced crime, including rape, domestic abuse, coercion, modern slavery or sexual exploitation, and those living in the areas of highest deprivation are twice as likely to use these services, the letter noted.
The letter said: ‘There is some evidence that some contractors are being funded below the level of core costs (particularly for surgical procedures) and the overall position highlights significant continuity risks given the small numbers of providers we rely on.’
The commissioner said that fragility being seen in services needs to be addressed and ICBs will be required to take action by the end of July.
This includes agreeing and adopting appropriate local referral pathways and putting in place shared plans to respond to acute service disruption and cases where rising wait times risks limiting access to abortion services.
ICBs will also need to ensure that contracts for 2024/25 are sustainable and pay realistic prices for care.
NHS England will be working with regional commissioners to stabilise provision of abortion services.
A spokesperson for the British Pregnancy Advisory Service, one of the charities providing NHS abortion services, said: ‘Abortion is an essential service, with one in three women having an abortion over their lifetime.
‘Despite this, there has been longstanding underfunding and lack of integrated working across health networks that has seriously endangered the sustainability of the sector.’
They added that the demand for abortion has been increasing since 2017, and with the cost of living crisis BPAS has seen a significant increase in the number of women who need care.
‘This has put additional pressure on services in terms of staffing, funding, and the availability of timely local services. This is even more the case for surgical procedures where the number of trained doctors able to provide more specialised care has been dwindling.’
Figures show that in more than one in four conceptions in England and Wales resulted in abortion in 2021 when more than 200,000 procedures were performed.
Data from the first six months of 2022 – the most recent published figures – also showed a 17% increase in demand for abortion service.
A version of this story was first published on our sister title Pulse.
