Sands is thrilled that after five years of championing the need to establish good quality in-hospital reviews of care when a baby dies, the government has commissioned a collaboration led by MBRRACE-UK, to develop a national Perinatal Mortality Review Tool (PMRT).

This will be a free, on-line tool which hospital staff can use to help them understand why a baby has died and whether there are any lessons to learn from the death to save future lives. Crucially the new review tool will include ways of offering parents the opportunity to give their views of events leading up to their baby’s death and to receive feedback once the review concludes its work.

Sands has been calling for improved understanding of events around a baby’s death since 2012. Too often after the death of a baby, families go home without the fullest picture possible about their care and the circumstances leading up to their baby’s death. While not all deaths can be prevented, we know from research that up to 6 out of 10 stillbirths occurring before birth close to a baby’s due date, are potentially avoidable (MBRRACE-UK confidential enquiry into babies who died after 37 weeks of pregnancy before birth ‘antepartum term  stillbirths’). 

The need for better, more robust review has been highlighted by several national reports including the National Maternity Review report, Better Births and the Kirkup Report. The Kirkup report found that lessons were not learnt from a series of avoidable deaths of babies and a mother at a Cumbrian hospital, resulting in tragedies that might have been prevented and Sands co-chaired a task and finish group with the Department of Health (DH) to establish what data would be needed for in-hospital reviews and finished that work in 2015.

The Health Quality Improvement Partnership has now commissioned a collaborative led by MBRRACE-UK  (Mothers and Babies: Reducing Risk through Audit and Confidential Enquiries across the UK) which includes representatives from Sands, researchers from the PARENTS2 study (looking at parents’ role in review), the British Association of Perinatal Medicine, the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives.

Sands aim, as part of the collaboration, is to ensure that Duty of Candour is upheld and that parents can share their experience as part of the review process, as well as receive feedback about the results of the review.

The new national Standardised Perinatal Review Tool (PMRT) will be piloted over the summer, and available by the end of 2017. It’s being funded by the governments of England, Scotland and Wales and will be free for units to use.

For more information visit the NPEU website.

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