QVEMTOPS one year on: care provided and lessons learnt

One in three Australian women will experience an unintended pregnancy in their lifetime. In 30.4% of these pregnancies, the woman/pregnant person will choose to terminate their pregnancy. However, access to termination of pregnancy care is highly uneven.

In 2023, the Australian Senate Report ‘Ending the postcode lottery: Addressing barriers to sexual, maternity and reproductive health care in Australia' highlighted the challenges and inequity women and pregnant people in Australia face accessing a termination of pregnancy. As a consumer consulted for the Queensland Termination of Pregnancy action plan stated: "At the time I was most vulnerable, I felt like I was passed from pillar to post reliving all the trauma again and again in an attempt to get treatment."

The Queensland Virtual Early Medical Termination of Pregnancy Service (QVEMTOPS) was set up to improve access and equity in reproductive care for Queenslanders wanting an early medical termination of pregnancy (less than nine weeks).

In the 2025 Clinical Showcase we presented on the development of QVEMTOPS, in 2026 we will focus on outcomes from the first year of service delivery, including patient reported experience measures, ongoing innovation such as the use of e-consents and lessons learnt.

Routine data collection from QVEMTOPS showed that the service was timely, safe, equitable, efficient and person-centred.

QVEMTOPS numbers increased significantly over 2025 and 2026. Around two thirds of patients who referred into the service went on to receive medication for termination of pregnancy with the others having a range of outcomes including referral, accessing alternate services or not requiring care. Discussions with other hospital and health services showed that they also saw increasing numbers during this time, so QVEMTOPS care represented an unmet health need rather providing care otherwise provided by HHSs.

Almost four out of five patients accessing QVEMTOPS were identified as belonging to a priority population, showing that QVEMTOPS is meeting its goal of improving reproductive access and equity. Close to one in four patients proceeded to medical termination of pregnancy without ultrasound scan following the Queensland Clinical Guidelines and follow-up (although incomplete) showed <1% serious complication rate with no serious complications in the 'No-scan" cohort.

Of patients that completed the PREMS, 94% rated the overall service as very good, 5% as good and 1% as adequate with none rating it poor or very poor. 98% felt that they were always treated with dignity and respect and were involved in their decisions and 96% always felt listened to during their care in QVEMTOPS. 87% of patients took the opportunity to write free text positive feedback and 12% wrote in a comment for service improvement.

The service also engaged in ongoing innovation with the roll-out of e-consenting and endorsed midwife prescribers. For the e-consenting process, the clinician doing the consent uses an online form with all the information that the current written consents contain but which is then delivered to the patient via their preferred method (identified during the referral process) - email, phone or both. Patients receive the patient information form first and then proceed onto a digital signature, the clinician also signs digitally, and patients can elect to receive a copy of their information. This form is then upload automatically into the iEMR within 24 hours. Patients and clinicians alike responded positively to the introduction of e-consenting however lessons learnt include the challenges of innovation post-project launch as a clinical care rapidly increases.

Endorsed Midwifery prescription was introduced into QVEMTOPS in October 2025 and has been increased as more clinical midwives become endorsed. This has been a smooth transition as midwives were already providing care up until the point of consent and prescription as well as after-care as well as increasing flexibility - for example - to provide contraceptive scripts during follow-up consultations.

Through 2026 and beyond, QVEMTOPS plans to streamline provision of care while continuing to provide a high-quality person-centred service, with the likely next addition being the use of AI during consultations.

Commonwealth of Australia. (2023). Ending the postcode lottery: Addressing barriers to sexual, maternity and reproductive healthcare in Australia. The Senate, Community Affairs References Committee.  Ending the postcode lottery: Addressing barriers to sexual, maternity and reproductive healthcare in Australia (aph.gov.au)

Queensland Health. (2024). Termination of Pregnancy Action Plan 2032. Queensland Government. Termination-of-Pregnancy-Plan_Digital.pdf (health.qld.gov.au)

Rowe H, Holton S, Kirkman M, et al. (2016) Prevalence and distribution of unintended pregnancy: The understanding fertility management in Australia national survey. Aust N Z J Public Health; 40(2):104-9. Doi:10.111/1753-6405.12461

Taft AJ, Shankar M, Black KI, et al. (2018) Unintended and unwanted pregnancy in Australia: A cross-sectional, national random telephone survey of prevalence and outcomes. Med J Aus;209(9):407-08