Earlier this year, NHS Forth Valley carried out an internal review of the stillbirths which had occurred during 2016 as, although the rate for the second half of the year was in line with previous years, the rate for the first half of the year was higher than the national average.
The internal review did not identify any significant issues or concerns and concluded that, in the vast majority of cases, there were complex underlying factors which meant that the stillbirths sadly could not have been prevented. These included fetal abnormalities, genetic conditions, trauma injuries and underlying health issues. The internal review also identified a small number of cases (four) where it was felt that the care could have been improved, although this may not necessarily have altered the outcome.
NHS Forth Valley also commissioned an External Review to ensure that all aspects of clinical care were independently reviewed by specialist staff. It concluded that care had been delivered to a consistently high standard and that, in many cases, there were significant underlying risk factors. The reviewers noted a number of areas of good practice including NHS Forth Valley’s involvement in a number of national initiatives to identify women at risk of stillbirth, along with the recruitment of extra staff to support these developments. The report also concluded that the improvements outlined in the internal review for four of the cases were very unlikely to have influenced the outcomes. A small number of minor areas for development, mainly in relation to administration and documentation, were outlined in the report, none of which was felt would have affected the outcome of any of the stillbirths. Work has already been undertaken to address these.
Gillian Morton, NHS Forth Valley’s, Head of Midwifery, said: “I am pleased that the External Review concluded that the quality of care delivered by our local maternity staff was of a consistently high standard. I am aware that some of the coverage about the review may have concerned local women and impacted on the morale of local staff. I therefore hope that the findings of both reviews will provide some reassurance and restore confidence in our local maternity services.
“Sadly, it is not possible to prevent every stillbirth however we remain committed to the ongoing delivery of high quality, safe and effective maternity care. We shall also continue to monitor our outcomes, review any cases on an individual basis and act on any learning identified.”
Issued by NHS Forth Valley’s Communications Department – 01786 457243.
Additional Information
National guidance recommends that all NHS boards should monitor their stillbirth rates and carry out reviews in response to any clusters or increase in rates compared to the national average.
The External Review confirmed that the internal review process had been carried out to a high standard and noted the Health Board’s decision to commission an external review demonstrated a commitment to openness and transparency.
All stillbirths are reviewed on an individual basis by a multidisciplinary team and the outcome is shared with the family at that time. Although, in many cases, it is not possible to prevent stillbirths, action would be taken to address any issues or learning identified.
Over the last five years the stillbirth rate in Forth Valley has been below the national average and, although there was an increase in the first half of 2016 which prompted the review, the numbers have also fallen consistently since then.