Recurring red flags: A retrospective study of MBRRACE-UK Perinatal Mortality Surveillance (2015-21) to identify maternity services most consistently reporting higher-than-average deaths

Abstract

Background This study aimed to identify hospital trusts in England most consistently reporting higher-than-average rates of extended perinatal mortality (EPM), including stillbirths and neonatal deaths. Methods We conducted a retrospective study of MBRRACE-UK Perinatal Mortality Surveillance Reports (2015-21) comparing EPM rates for births occurring in 124 hospital trusts in England between 2013 and 2019. Utilizing MBRRACE-UK definitions and designations, including coloured bands (red and amber indicate higher death rates), we devised a scoring method to determine which trusts most consistently reported higher-than-average rates of EPM throughout seven years. Results We identified 23 (18.5% of 124) 'red flag' trusts most consistently falling into MBRRACE-UK red and amber bands. They included Shrewsbury and Telford Hospitals NHS Trust (SaTH) and East Kent Hospitals University Trust, both under investigation during the parliamentary Health and Social Care Committee's inquiry into the safety of maternity services in England. Seven trusts, including SaTH, reported higher-than-average deaths in all seven years. Indications of regional patterns were evident. Conclusions By examining maternity services mortality data over an extended period, patterns of clinical significance may emerge. We found evidence of a minority of trusts in England consistently reporting higher-than-average rates of EPM. These red flags may warrant further attention.