Marie Stopes International, one of Britain's largest abortion providers, has been accused of linking staff performance bonus pay to key performance indicators (KPIs) which included encouraging women to go through with the various procedures on offer at the clinic.
One section of the Care Quality Commission (CQC) report on the Marie Stopes centre in Maidstone, Kent, infers that staff felt pressure to encourage women to go through with abortions because if they did not, it would be marked as a negative 'Did Not Proceed' on their KPIs.
Under a section of the report discussing access to and flow of abortion procedures, the report states: "Staff were concerned that 'Did Not Proceed', the term
used when women decided not to proceed with
treatment, was measured as a KPI and linked to their
performance bonus. They felt that this encouraged staff
to ensure that patients underwent procedures."
The watchdog says: "Minutes dated 15 July 2015 recorded a company wide focus on 'Do not proceeds'. Where a patient of less than 5 weeks and three days gestation had decided not to go ahead with the termination they were being called and offered a later appointment."
It is not clear what the nature of this new appointment might have been.
Staff told inspectors that the clinic had a "very target driven culture with a timed slot for each patient. All the registered nursing staff we spoke with felt patient care and safety were compromised by the need to 'Keep on top of the list.' One staff member described it as "feeling like a hamster in a wheel" and said the word, 'Cattle market' came up quite a lot," according to the report.
"Staff were also concerned that the pressurised environment and linking of KPIs to performance bonuses meant that there was a culture that worked against patient choice. They talked about implants being fitted whilst the patient was sedated (at the same time as the operation) and the limited time available to discuss the choices prior to this," said CQC.
The watchdog carried out the inspection last year, and published their report on 2 October. CQC said an earlier draft report on their report was taken down from their website after being published in error.
In a statement, Marie Stopes UK managing director Richard Bentley said: "It's true that our team members are measured against key performance indicators (KPIs) that relate to quality and client care.
"However, none of these KPIs relate to client numbers, and it is untrue that any member of our staff receives a performance related bonus for the number of clients they treat. Informed choice is at the heart of our charity's mission, and every woman we serve is talked through her options before booking an appointment and again at the clinic."
Marie Stopes, a not for profit group founded in 1976, is the UK's second largest abortion provider and "provides reproductive and sexual health services through the NHS for over 100,000 women and men," according to its website.