University of Bristol and North Bristol NHS Trust (NBT) team part of Health Foundation’s £1.5 million innovation programme

The initiative from the University and NBT, in close collaboration with the International Stillbirth Alliance, the University of Manchester and other national and international academic networks, aims to improve the perinatal mortality review (PNMR) that takes place in each hospital after the death of a baby, by involving parents in the process.  This research is in response to a national Confidential Enquiry (MBRRACE-UK 2015) and a Department of Health (DoH) Committee, who recommended that parents should be involved in the PNMR.

In the UK more than 5,000 babies a year die before or shortly after birth but the review processes across the country are not consistent. Reviews of the death of a baby greatly differ across the UK, and in most Units bereaved parents are not involved in the PNMR. In the recent national Confidential Enquiry (MBRRACE) there was evidence that parents’ concerns were included in the review for only five percent of babies that had died.

The proposed study aims to address this immediately by implementing parental involvement in the perinatal review at two UK NHS healthcare Trusts, and applying the lessons we learn to finalise an improved, innovative PNMR process, with the incorporation of parental input, which will inform national and international policy and that could be rolled out in the NHS as a direct output from this study. Over the course of the programme the team will develop its innovative idea and approach, put it into practice and gather evidence about how the innovation improves the quality of health care. This innovative approach will be fully integrated in a new national standardised perinatal mortality review process.

The team will be led by NIHR Academic Clinical Lecturer Dr Christy Burden, supported by Consultant Senior Lecturer Dr Dimitrios Siassakos, and a further team of experienced academics and international experts in bereavement care.

Dr Burden said: “This has been a neglected area of research in the past. We hope the study will directly improve the experience of the patients involved in the pilot study as well as future bereaved parents.

“We aim to improve the experience of the patients involved in the study and eventually bereaved parents across the UK.”

Dr Siassakos, a Consultant Senior Lecturer at North Bristol NHS Trust and the University of Bristol, said: “A national confidential enquiry (MBRRACE-UK 2015), a national audit of stillbirth (Each Baby Counts 2016), and two recent briefing notes by the Parliament Office for Science and Technology have all underlined the importance of involving parents in the hospital review of their baby’s death.

“This study, funded by the Health Foundation, will not only investigate the most appropriate, feasible, and effective way to involve parents, it will also inform a new standardised process across the UK.”

Sarah Henderson, Associate Director from the Health Foundation, said: “We are very excited to be working with such a high-calibre of teams, who all have great innovative ideas. As an organisation we are keen to support innovation at the frontline across all sectors of health and care services, and I am pleased that we will be able to support these ambitious teams to develop and test their ideas over the next year.

“Our aim is to promote the effectiveness and impact of the teams’ innovations and show how they have succeeded in improving the quality of health care, with the intention of these being widely adopted across the UK.”

The programme will run for 15 months and each project will receive up to £75,000 of funding to support the implementation and evaluation of the project.