Nurse-led telephone consultation and outpatient local anaesthetic abortion: a pilot project.

OBJECTIVES The study objectives were to improve access to earlier and safer abortion and to offer women a wider choice of method of termination of pregnancy (TOP). METHODS The study comprised two pilot projects conducted in a teaching hospital to assess the feasibility of (1) a telephone booking clinic and (2) a local anaesthetic outpatient surgical termination of pregnancy (LA-STOP) service. The main outcome measures were the uptake of services by referrers and patients, staff acceptability and cost. RESULTS Demand from referrers for the telephone booking clinic was greater than could be accommodated by the service. Telephone consultation was popular with patients as it was carried out at their convenience in their homes, and with staff as it reduced clinic assessment time. Some staff members felt that consulting over the telephone affected their assessment of the patient's emotional status. Outpatient LA-STOP seemed well accepted by both staff and patients as it offered patients a convenient and safe method of early abortion. A preliminary costing indicated a net saving plus increased service capacity. CONCLUSIONS The pilots suggest that the introduction of a telephone booking clinic and LA-STOP service into existing hospital services is feasible and cost effective. Further research is required to evaluate the potential for reducing waiting times and the gestations at which terminations are carried out.