Child death review processes in paediatric intensive care units: a national survey of practice against statutory and operational guidance.

Abstract

In 2018, Her Majesty's Government published statutory and operational guidance setting out how children's deaths are reviewed in England, aiming to ensure practice is standardised and review of each child's death is of uniform quality. A national survey of paediatric intensive care units (PICUs) to review the implementation of the statutory guidance. Online survey exploring child death review (CDR) practices against expected operational standards across three domains: (1) Logistics and administration of the CDR process, (2) the CDR meeting and (3) communication with bereaved families. 19/21 (91%) English PICUs, 1/1 Welsh and 1/1 Northern Irish PICUs responded to the survey request. 6/21 PICUs reported no remuneration for their CDR work. 18/21 reported routinely notifying the local child death overview panel of a child death within 48 hours as per statutory guidance. 8/21 (38%) achieved the current National Health Service England quality outcome target of holding the CDR meeting within 3 months of a child's death. 17/21 (81%) PICUs appointed a 'key worker' as a single point of access to bereaved families. 12/21 (52%) PICUs routinely offered families the option to be informed of the outcome of the CDR meeting at bereavement follow-up. This survey is the first to report on CDR practices in PICUs. It highlights significant variation between units in the application of national guidance. It suggests that further recommendations are required in the application of the statutory guidance to ensure greater parity between units, that learning is shared effectively between agencies and that all bereaved families receive the appropriate information and support.