Our challenges 14 Financial vulnerability • Despite recent financial recovery, BPAS remains financially vulnerable. The organisation faces rising operational costs, limited cash reserves, and reliance on NHS contracts, which exposes it to risks from contract losses or changes in commissioning Underutilised and ageing estate • BPAS clinics are underutilised, with some operating at only 43% capacity. Many clinics are aging, require significant refurbishment, and face escalating rental costs. Additionally, several sites are flagged for urgent relocation due to inadequate safety measures like EGRESS Competitive commissioning environment • The shift to the Any Qualified Provider (AQP) model increases competition for contracts. This shift threatens our market position and destabilises our monopoly in some regions. This could result in lost contracts and income, making patient experience, engagement, and service quality critical for maintaining case-loads. Conversely AQP will enable BPAS to enter into new commissioning relationships and geographies Workforce morale and retention • Staff morale has been impacted by financial challenges and redundancies. There has been a lack of investment in learning, development, and clear career progression, further contributing to workforce dissatisfaction Model of care and patient pathways • BPAS’s current clinical pathways are primarily developed based on contractual requirements rather than a unified clinical care model. Despite delivering four clinical services we have multiple and complex pathways that do not deliver the best experience for our patients or our staff Fragmented reproductive health care system • The current commissioning model separates services like contraception and abortion care, leading to fragmented care and inconsistent service delivery. There is opportunity for BPAS to provide standalone contraception that offers a seamless patient experience across the full life-cycle and attracts a diversified revenue stream from local authorities Outdated abortion law • UK abortion law remains outdated, restricting nurse and midwife involvement in surgical abortions and relying on criminal statutes from 1861. This limits BPAS’s ability to offer more flexible, patient-centred care and contributes to extended waiting times CQC regulatory challenges • Only half of BPAS clinics are rated as "Good" or "Outstanding" by the Care Quality Commission (CQC). (Both competitors have 100% good or outstanding) We need to ensure consistent regulatory compliance across all clinics to avoid enforcement actions and maintain service quality Technological and digital infrastructure • As demand for telemedicine and digital first solutions grow, we face the challenge of improving our digital infrastructure to support telehealth and other digital services, ensuring we can scale and meet patient needs efficiently whilst reducing our cost to serve Each of these challenges also presents an opportunity to reduce our central costs through investment in digital services and tools, review our current model of care and the infrastructure needed to deliver this, relaunch our values placing our people at the heart of our business, and continue to be the leading voice of advocacy and research within the sector.
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