One of Britain's biggest abortion providers put women at risk by failing to adequately train staff and neglecting to obtain proper consent from patients, a watchdog report has revealed.
Staff at Marie Stopes International (MSI) had "limited training" in resuscitation and clinicians were found to be "bulk-signing" forms authorising abortions, the Care Quality Commission (CQC) said.
Doctors in one location, who were observed obtaining consent from a woman with a learning disability, failed to ensure she understood the procedure and handled the consultation "poorly and insensitively", according to the report.
Some staff obtaining consent from patients also appeared to have insufficient knowledge of procedures, the CQC added.
The family planning provider suspended surgical abortions for girls under 18 and vulnerable women in August after concerns were raised by the CQC about patient safety.
It also halted terminations under general anaesthetic or conscious sedation and suspended all surgical terminations at the provider's Norwich centre.
But the organisation, which performs around 70,000 abortions every year, was allowed to resume services in October after satisfying the CQC that it had improved standards.
The report found that 2,634 incidents had been recorded at MSI locations between 2015 and 2016 - a rise of 704 from the previous year - but the organisation had provided "limited" explanation as to why this had happened.
Professor Edward Baker, deputy chief inspector of hospitals at the CQC, said a number of "serious concerns" had been raised following inspections of MSI between April and August.
"Our concerns at a corporate level – particularly around governance arrangements, staff training, and around patient safety and safeguarding protocols – did not give us the necessary assurance that patients would be protected from avoidable harm at all times, that possible safeguarding concerns could be identified and that incidents could be reported and learned from," he said.
"While we recognise that Marie Stopes International has made progress since our inspections, we will continue to monitor its services very closely and our planned re-inspections will determine exactly how embedded these improvements have been.
"We will not hesitate to take further action, if necessary in order to guarantee this provider meets the standard of care we expect and that its patients deserve."
Suzanne Ash, interim managing director at Marie Stopes UK, said: "We have worked hard with the Care Quality Commission to regain compliance and we're grateful to them for their assistance.
"Since the inspections, we've made considerable changes to our management, governance and assurance processes, including extensive training of staff, and updating of policies.
"We have learned from this, and intend to continue our focus on providing the safe and compassionate care that women expect and deserve."