Perinatal Mortality Review Tool

What is the PMRT?

The fundamental aim of the Perinatal Mortality Review Tool (PMRT) is to support objective, robust and standardised local reviews of care when babies die. This is to provide answers for bereaved parents and their families about whether the care that they and their baby received was appropriately safe and personalised or whether different care may have changed the outcome. The second, but nonetheless important, aim is to ensure local and national learning results from review findings to improve care, reduce safety-related adverse events, and prevent future baby deaths.

The PMRT is designed to support the review of baby deaths, from 22 weeks' gestation onwards, including late miscarriages, stillbirths, and neonatal deaths. For about 90% of parents, the PMRT review process is likely to be the only hospital review of their baby's death that will take place.

The aim of the PMRT programme is to support standardised perinatal mortality reviews across NHS maternity and neonatal units in England, Scotland, Wales and Northern Ireland. The tool supports:

• Systematic, multidisciplinary, high quality reviews of the circumstances and care leading up to and surrounding each stillbirth and neonatal death, and the deaths of babies who die in the post-neonatal period having received neonatal care;

• Active communication with parents to ensure they are told that a review of their care and that of their baby will be carried out and how they can contribute to the process;

• A structured process of review, learning, reporting and actions to improve future care;

• Coming to a clear understanding of why each baby died, accepting that this may not always be possible even when full clinical investigations have been undertaken; this will involve a grading of the care provided;

• Production of a technical clinical report. This should be used for discussion with parents from which a meaningful, plain language explanation of why their baby died whether, with different actions, the death of their baby might have been prevented, and any implications for future pregnancies they may have;

• Other reports from the tool can be generated from the tool to enable organisations providing and commissioning care to identify emerging themes across a number of deaths to support learning and changes in the delivery and commissioning of care to improve future care and prevent the future deaths which are avoidable;

• Production of national reports of the themes and trends associated with perinatal deaths to enable national lessons to be learned from the nation-wide system of reviews.

• Parents whose baby has died have the greatest interest of all in the review of their baby's death. Alongside the national annual reports an infographic of the main technical report is written specifically for families and the wider public. This will help local NHS services and baby loss charities to help parents engage with the local review process and improvements in care.

• Implementation support materials and parent engagement materials are available to support the conduct of high quality reviews and the use of the PMRT.

Funding: The PMRT programme is commissioned by the Department of Health and Social Care for England and on behalf of the Welsh, Scottish and Northern Ireland Governments; as a consequence the tool is free for use by Trusts and Health Boards in England, Wales, Scotland and Northern Ireland.