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Proposals launched for new system in investigating stillbirths

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The government has proposed a new independent system for investigating full-term stillbirths, after concerns were raised about the “inconsistency” of the current process.

As part of a consultation launched today, the Department for Health and Social Care have proposed giving coroners the power to investigate all full-term stillbirths, in a bid to help provide parents with vital information on the death of their child.

“We want to do everything we can to make pregnancy safer, by continually learning to improve the care on offer”

Jackie Doyle-Price

Healthcare professionals are now being asked to share their views on the proposed changes.

Under the current system, coroners can only hold inquests for babies who have shown signs of life after being born and cannot investigate where the pregnancy appeared healthy, but the baby was ultimately stillborn.

Where a stillborn occurs, the Healthcare Safety Investigation Branch (HSIB), which is funded by the department and hosted by NHS Improvement, must investigate the death.

However, according to the DHSC, while many parents are satisfied with the existing process, some have raised concerns about the “inconsistency of investigations” and have “called for a more transparent and independent system”.

Consequently, ministers are now asking for views on whether coroners should be able to investigate stillbirths occurring from 37 weeks pregnancy. 

“This is a complex issue and it’s important we get it right by listening carefully to those who are affected by these issues”

Jackie Doyle-Price

As judicial office holders, coroners would not only be able to provide parents with much needed answers but also make recommendations to prevent future avoidable deaths, the DHSC noted.

Coroners will not have to gain consent or permission from any third party in exercising this power, it added.

In addition, the new system will ensure that both bereaved parents and medical staff are involved at all stages of the investigation process.

The department highlighted that the new coronial investigations will not replace the current investigations undertaken by hospital or NHS agencies, including HSIB.

Nursing Times approached HSIB over the claims of inconsistencies, but it did not respond directly to this.

Instead a spokeswoman said: “We welcome any proposals that aim to improve maternity safety and we look forward to the outcome of this consultation.”

Health minister Jackie Doyle-Price said: “We want to do everything we can to make pregnancy safer, by continually learning to improve the care on offer so fewer people have to experience the terrible tragedy of losing a child and those who do get the answers and support they deserve.”

Ms Doyle-Price highlighted that the rates of stillbirths in England are at the “lowest of record” but she noted that the government was committed to delivering the ambitions of the NHS Long Term Plan to “accelerate action to halve this number by 2025”.

Conservative Party

Jackie Doyle-Price

Jackie Doyle-Price

The government explained that despite year-on-year falls in the proportions of pregnancies that end in a stillbirth, it was “clear that more must be done”. The department said that the measures launched today were an important step towards delivering its commitment to reducing the rate of stillbirths.

The consultation, which is joint with the Ministry of Justice, is seeking views, from bereaved parents, the organisations that support them or that provide advice to pregnant women, researchers, health professionals and healthcare providers, as well as those working for coronial services.

“This is a complex issue and it’s important we get it right by listening carefully to those who are affected by these issues, so I urge everybody to have their say on this consultation,” said Ms Doyle-Price.

“By sharing your experiences, you can ensure any decision we make puts women, loved ones and their babies first,” she said.

Justice minister Edward Argar said that every case must be “thoroughly and independently” investigated. He noted that the new proposals would ensure bereaved parents “have their voices heard” and “allow lessons to be learnt” to prevent future stillbirths.

Kate Mulley, director of research education and policy at stillbirth’s charity Sands, reiterated the importance of taking into account the views of bereaved parents when determining the changes in the role of coroners.

The consultation is due to run for 12 weeks, closing on 18 June 2019 and proposals will apply in England and Wales.

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