External reviews

Information that can be gathered through performance and quality reporting systems, such as national audit programs and external review commissions, can be key intelligence in building a culture that supports quality improvement 34 35. There are a number of external review processes relevant to the quality regulation of perinatal optimisation detailed below:

• PMRT (Perinatal Mortality Review Tool)and MBRRACE (Mothers and Babies: Reducing Risk through Confidential Enquiries) reports: Preterm neonatal deaths and stillbirths are reviewed within this national standardised review process with parent input.
• CQC (Care Quality Commission) Quality of Care report: (NHSE): The publicly available Quality of Care report following CQC inspection provides transparency between healthcare provider and patients around perinatal teamwork and patient safety.
• GIRFT (Getting It Right First Time) report (NHSE): The GIRFT bases reporting on data analysis from service reporting and, in engagement with service leads, provides a framework for service improvement around perinatal optimisation.
• MCQIC-SPSP Action Plan (NHS Scotland): similar to GIRFT, MCQIC-SPSP identifies areas for improvement from the Preterm Wellbeing Package data national QI programme and engages with clinical leads to develop and support improvement plans.
• Healthcare Safety Investigation Branch reports (NHS England): Although these focus on babies born after 37 weeks’ gestation, the reports can give valuable insight into the culture and working within the unit.
• Peer review reports (NHS Wales).
• Invited Reviews (RCPCH, RCOG, RCoA, RCM and RCN): In response to concerns about service provision, safety, team dynamics, compliance with standards and service reconfiguration, Trusts may invite clinically-led peer reviews from bodies such as the Royal Colleges to advise and support teams.