Setting up an outpatient service for early medical termination

Objectives In parts of the UK, demand for termination of pregnancy exceeds local availability on the National Health Service. The study objective was to report on setting up and running a new outpatient service for early medical termination under 7 weeks' gestation. Methods We describe the process of setting up the clinic within the confines of the Abortion Act 1967, the training of staff, acquisition of resources, cost analysis and negotiations with the Primary Care Trust. We report on running the service in the first 12 months, difficulties encountered and how these have been overcome. Our experience is compared with the limited published data available. Results Of 171 patients referred in the first year, 148 were offered an appointment and 100 women completed outpatient treatment for medical termination under 7 weeks' gestation. 90% of patients attended follow-up at 2 weeks and the remainder were contacted by telephone. Clinical outcomes were similar to those reported in the literature apart from initially higher numbers of women undergoing evacuation of retained products of conception. The estimated cost per case in the first year was 156 pound, which represented a considerable cost saving compared to 498 pound for surgical termination and 423 pound for inpatient medical termination. Conclusions Our service is successful, viable for the future and has acceptably good patient outcomes, which are improving all the time.