Bereavement and early birth losses
Pregnancy loss and baby loss is devastating for patients. During this difficult time, it’s crucial that they’re provided with compassionate care and support.
If you are supporting a patient affected by pregnancy loss or baby loss, you can find resources and guidance relevant to the country to help you on our useful resources page.
As well as making sure you're providing the best bereavement care for your patient, there are a range of organisations and resources that you can signpost them to for further support.
If you have a leadership role or management responsibilities
Consider the bereavement care training provided by Sands, which includes a focus on multidisciplinary teams in secondary care.
For those in primary care, consider the training they offer to community services focused on the impacts of grief and trauma on mental health.
Ockenden review: summary of findings, conclusions and essential actions
‘Trusts must ensure that women who have suffered pregnancy loss have appropriate bereavement care services.’
Decision making when neonates may be approaching end of life
Identifying the best interests of children or young people who may be approaching the end of life can be challenging. This is particularly the case where there are uncertainties about the long-term outcomes of treatment and in extremely premature neonates whose prospects for survival are known to be very poor.
We provide guidance on decision making, being sensitive to the concerns of parents, neonates and infants and resolving disagreements in paragraphs 92–98 and 106–108 in Treatment and care towards end of life.
Our professional standards
84. Death and bereavement affect different people in different ways, and an individual’s response will be influenced by factors such as their beliefs, culture, religion and values. You must show respect for and respond sensitively to the wishes and needs of the bereaved, taking into account what you know of the patient’s wishes about what should happen after their death, including their views about sharing information. You should be prepared to offer support and assistance to the bereaved, for example, by explaining where they can get information about, and help with, the administrative practicalities following a death; or by involving other members of the team, such as nursing, chaplaincy or bereavement care staff.
Treatment and care towards the end of life: good practice in decision making
Seeking feedback from patients
In addition to listening to patients during their care, it’s important to seek feedback from patients who have used your services. Doing so can demonstrate areas that have been particularly successful and effective for patients, as well as highlighting potential areas for improvement.
An NHS England case study on seeking maternity feedback to improve care provides an example of an initiative undertaken at the Royal Oldham Hospital to improve how patient feedback was collected and used to improve their maternity services. It had positive impacts – including better outcomes for patients, a better experience for both patients and staff, and an overall better use of resources.
Working with third sector organisations and co-producing services
There can also be value in working with third sector organisations to reach different areas of the community, as well as working closely with patients to co-produce services. This can have a particularly positive impact and improve access to care for ethnic minority patients and where English is not their first language. This is set out by NHS England in their equity and equality guidance for local maternity systems which emphasises the benefits that co-production can have on reducing health inequalities.
MBRRACE-UK highlights the positive impact that involving community voices in service development or processes can have on finding solutions and producing change. In England, Maternity Voices Partnerships (MVP) – and in Scotland, Wales and Northern Ireland Maternity Services Liaison Committees (MSLC) – can help identify parents and communities who can support co-production work.
In England, Wales and Scotland, you can find your local MVP/ MSLC and in Northern Ireland details of your local MSLC should be available on your Health and Social Care Trust’s website.
On our useful resources page, you can find information on seeking feedback from patients and co-production. These have been split by countries in the UK.
You can find case studies from several midwives, a patient advocate, and a doctor focused on learning together on the NMC website.
