National Mortality Case Record Review – Annual Report 2018

Just under half of deaths in England occur in hospital and around one in three hospital beds is occupied by someone who is in the last 12 months of their life. A large and growing proportion of the hospital population is people living with age-related problems including frailty and dementia, and there are adults of all ages living with (often multiple) long-term medical conditions.

The NMCRR programme is contracted to develop and offer to all NHS hospitals in England and Scotland a validated Structured Judgment Review (SJR) tool for case notes of patients who have died, alongside delivering educational support for local reviewers and trainers of those reviewers. The aim of the programme is to establish and roll-out a standardised methodology and process for retrospective case record review (RCRR) for adult acute care deaths in England and Scotland in order to support improvement by understanding and learning about problems in care that may have contributed to patients’ deaths.

This report sets out to describe the aims and objectives, the detail of the development and implementation of the programme and specifically focuses on how the findings from mortality reviews are translated into improvements in healthcare.

The feedback from practitioners using the tool, and from organisational leaders using its findings to learn from deaths and use the learning for improvement, has been overwhelmingly positive. Many trusts have now used the learning as the starting point for locally led quality improvement work.

To download the full report click on the link below.

To read the press release click here