Perinatal Mortality Review Tool (PMRT).
Case reference FOI2026/01151
Received 7 April 2026
Published 9 July 2026
Request
QUESTION 1: Between the period 1/1/2021 and 31/12/ 2025, please provide the following information: a. How many late miscarriages, stillbirths and neonatal deaths were identified as meeting the criteria for a PMRT review? b. In what percentage of PMRT reviews was a clinician external to the trust part of the reviewing team?
QUESTION 2: For Stillbirths & Late Fetal Losses, please provide: Grading of care of the mother and baby up to the point that the baby was confirmed as having died: A. No issues with care identified B. Care issues identified that would have made no difference to the outcome C. Care issues identified which may have made a difference to the outcome D. Care issues identified which were likely to have made a difference to the outcome
QUESTION 3: For Neonatal Deaths, please provide: Grading of care of the mother and baby up to the point of the birth of the baby: A. No issues with care identified B. Care issues identified that would have made no difference to the outcome C. Care issues identified which may have made a difference to the outcome D. Care issues identified which were likely to have made a difference to the outcome Grading of care of the baby from birth up to the death of her baby: A. No issues with care identified B. Care issues identified that would have made no difference to the outcome C. Care issues identified which may have made a difference to the outcome D. Care issues identified which were likely to have made a difference to the outcome
Response
Between the period 1/1/2021 and 31/12/ 2025, please provide the following information:
a. How many late miscarriages, stillbirths and neonatal deaths were identified as meeting the criteria for a PMRT review?
All mortality information is reported through MBRRACE and published on their website. The latest data published relates to 2024.
Data for 2025 has been submitted by Oxford University Hospitals to MBRRACE and it is expected to be published in Spring 2027. In the meantime, a section 22 exemption applies – intention to publish.
The births and deaths data requested (see list below) is reported on the MBRRACE website shown here:
https://www.npeu.ox.ac.uk/mbrrace-uk
You can also review the tool published by the University of Leicester here which is based on MBRRACE data:
https://timms.le.ac.uk/mbrrace-uk-perinatal-mortality/data-viewer/
Figures are also reported in the OUH public board meeting every quarter and the latest paper was shared in March 2026. You can find a link to these papers here:
https://www.ouh.nhs.uk/about/trust-board/meetings-and-papers/
b. In what percentage of PMRT reviews was a clinician external to the trust part of the reviewing team?
2021 - 0
2022 - 0
2023 - 0
2024 - 0
2025 - 82%.
Prior to 2025 it was not a requirement to capture external reviewers for PMRT reviews. Under the Maternity and Perinatal Incentive scheme year 7 which was launched in 2025, a minimum of 50% of the deaths reviewed an external member should be present at the multi-disciplinary review panel meeting.
QUESTION 2:
PMRT was introduced in 2018. Our quarterly PMRT reports are discussed within Trust Board meetings and are available on the Trust’s website here - the last report was presented in January 2026:
https://www.ouh.nhs.uk/about/trust-board/meetings-and-papers/
When interpreting these figures, it is important to note that they include deaths of babies being cared for jointly with other hospitals. These include babies born elsewhere but referred to OUH for tertiary care. Such deaths are recorded within OUH figures and not those of the referring hospital, which impacts the figures for all tertiary referral centres, including OUH which is one of the largest.
Every baby death (from 22 weeks’ gestation up until 28 days after being born) is reviewed in detail so we can fully understand what happened and whether improvements are required. We have a well‑established multidisciplinary process for undertaking PMRT reviews across the Thames Valley Network, with external reviewers to ensure independent scrutiny. This collaborative approach enables open sharing of learning across services and supports continuous improvement in the safety and quality of maternity care at OUH and across the region.
For Stillbirths & Late Fetal Losses, please provide:
Grading of care of the mother and baby up to the point that the baby was confirmed as having died:
A. No issues with care identified
B. Care issues identified that would have made no difference to the outcome
C. Care issues identified which may have made a difference to the outcome
D. Care issues identified which were likely to have made a difference to the outcome
|
2021 |
2022 |
2023 |
2024 |
2025 |
|
|
A |
6 |
8 |
17 |
4 |
10 |
|
B |
19 |
20 |
16 |
12 |
14 |
|
C |
6 |
<5 |
5 |
<5 |
<5 |
|
D |
0 |
0 |
0 |
<5 |
0 |
QUESTION 3:
For Neonatal Deaths, please provide:
Grading of care of the mother and baby up to the point of the birth of the baby:
A. No issues with care identified
B. Care issues identified that would have made no difference to the outcome
C. Care issues identified which may have made a difference to the outcome
D. Care issues identified which were likely to have made a difference to the outcome
|
2021 |
2022 |
2023 |
2024 |
2025 |
|
|
A |
18 |
13 |
8 |
9 |
6 |
|
B |
14 |
16 |
14 |
19 |
14 |
|
C |
5 |
5 |
<5 |
<5 |
5 |
|
D |
<5 |
1 |
0 |
<5 |
0 |
Grading of care of the baby from birth up to the death of her baby:
A. No issues with care identified
B. Care issues identified that would have made no difference to the outcome
C. Care issues identified which may have made a difference to the outcome
D. Care issues identified which were likely to have made a difference to the outcome
|
2021 |
2022 |
2023 |
2024 |
2025 |
|
|
A |
17 |
21 |
14 |
19 |
8 |
|
B |
15 |
16 |
10 |
10 |
17 |
|
C |
7 |
<5 |
<5 |
<5 |
0 |
|
D |
<5 |
0 |
0 |
<5 |
0 |
Please note: All the above values of <5% have been presented in this manner to prevent this data being person identifiable. This is done under section 40(2) of the FOIA.
Documents
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