1. Perinatal Mortality Review Tool ‘Review once, review well’

2. Why we need the PMRT

3. The PMRT – a tool to facilitate…

4. The PMRT – a tool to facilitate…

5. How the PMRT works…..

6. How the PMRT works…..

7. Review Process

8. Using the PMRT

9. Using the PMRT

10. Using the PMRT

11. Using the PMRT

12. Using the PMRT

13. Using the PMRT……factual questions

14. How the PMRT works…..tool tips

15. Tool tips……..

16. Using the PMRT…..assessing care

17. How the PMRT works…..

18. Using the PMRT

19. How the PMRT works…..

20. How the PMRT works…..

21. We recommend….

22. We recommend….

23. Implementation Support…

24. Other help and guidance

25. Where are we up to*?

26. Next steps………..

27. CNST Incentive Scheme (England)

28. Birmingham Women’s Hospital Experience - a three year journey to improve our review process

29. Birmingham Women’s Hospital Experience

30. Standard Operating Procedure

31. Standard Operating Procedure

32. Resources

33. BWH Experience /2017

34. Positive Findings

35. Governance

36. Issues we identified - Hypothermia

37. Issues we identified - IUGR

38. IUGR Actions

39. Issues we identified – neonatal sepsis

40. In Summary

41. Difficulties

42. The Way Forward

43. Acknowledgements

44. The MBRRACE-UK/PMRT collaboration

45. Expert group members