Midwives support call to roll out baby bereavement pathway

A report into a pilot project for the National Bereavement Care Pathway (NBCP) has recommended that it should now be rolled out across all NHS trusts in England. While midwifery leaders have supported the move, they warned that investment was also needed in training for frontline staff.

“We support the call for this to be introduced in NHS trusts across the country”

Gail Johnson

The pilot project was first introduced across 11 trusts in 2017 with the aim of helping to ensure bereaved parents were supported in the best way possible and to end the current postcode lottery facing parents and families whose baby has died before, during or shortly after birth.

In April 2018, the pilot was then expanded to a further 21 trusts. The report, published today by consultancy firm Fiveways, covers analysis of this second wave.

The pathway covers five experiences of pregnancy or baby loss, including miscarriage, termination of pregnancy for foetal anomaly, stillbirth, neonatal death and the sudden unexpected death of an infant up to 12 months.

The second wave of analysis and feedback on the project, published in the new report, found healthcare professionals felt that, as a result of the pathway, they now had consistent and clear guidelines to support them to provide good quality care for bereaved parents.

According to the report – titled Evaluation of the National Bereavement Care Pathway: Final Report (Wave 2) – 76% of healthcare professionals, including midwives, agreed that overall bereavement care had improved in their trust during the pilot period.

In addition, 54% agreed that the consistency of care had improved and 36% reported that there had been fewer mistakes since its introduction.

“Midwives and maternity support workers also appreciate the support this gives them to provide better care for bereaved families”

Gail Johnson

The survey also found the proportion of healthcare professionals who felt prepared to communicate with bereaved parents had increased from 88% to 92%.

Meanwhile, the amount of staff feeling capable to discuss bad news with bereaved parents had increased from 66% to 72%.

Those behind the report recommend that the next step would be to roll it out nationally, but also asked NHS leaders to increase emotional support for staff and give them access to bereavement care training.

Responding to the report, the Royal College of Midwives said it supported the call for the pathway’s roll out, but also asked the government to help fund ongoing bereavement training and education for midwives.

Education advisor at the RCM, Gail Johnson, said: “It is clear that this pathway works, and midwives and maternity support workers also appreciate the support this gives them to provide better care for bereaved families. We support the call for this to be introduced in NHS trusts across the country.

“We would like to see the government and trusts investing in this to ensure all parents get the support they need, and to fund ongoing education and training for midwives and their colleagues,” she said.

Conservative Party

Jackie Doyle-Price

Jackie Doyle-Price

The government minister responsible for leading on mental health policy, Jackie Doyle-Price, encouraged trusts around the country to adopt the pathway. 

She said: “Every stillbirth or baby loss is a tragedy and we remain absolutely committed to supporting parents through this difficult time.

“This independent evaluation shows that NBCP has already helped to strengthen the support for many bereaved families across the country, but there is more to do, and I would urge all NHS trusts to adopt this approach to ensure all care surrounding baby loss meets these consistent standards,” she said.

“Through our long-term plan for the NHS, we are also accelerating action to halve the number of stillbirths and neonatal deaths over the next five years and improving access to perinatal mental health care for mothers and their partners,” she added.

Clea Harmer, chief executive at the charity Sands, which is leading on the NBCP, also called for the pathway to be rolled out in light of the latest analysis on the pilots.


Clea Harmer

Clea Harmer

She said: “Sands is delighted that the independent evaluation of the NBCP has highlighted the impact excellent bereavement care can have for bereaved parents and on enhancing collaborative working amongst healthcare professionals, which has met the initial objectives that Sands and our partner organisations set out to achieve.

“The NBCP has made a huge difference to the lives of bereaved parents and healthcare professionals and has improved the care they receive,” she said. “We would like to see the pathway rolled out nationally, so that all bereaved parents receive the quality care they deserve.”

The 32 National Bereavement Care Pathway pilot sites 

Wave 1

  • Ipswich Hospital NHS Trust
  • Barking, Havering & Redbridge University Trust – Queens Hospital, Romford
  • Chelsea & Westminster NHS Foundation Trust including West Middlesex Hospital
  • Medway (Maritime) NHS Foundation Trust
  • Northern Devon Healthcare NHS Trust (Barnstaple Hospital)
  • Walsall Healthcare NHS Trust
  • Heart of England NHS Foundation Trust
  • Hull & East Yorkshire NHS Trust
  • York Teaching Hospital NHS Trust
  • Liverpool Women’s Hospital Trust
  • Wirral University Teaching Hospital

Wave 2

  • Alder Hey Children’s NHS Foundation Hospital,
  • Pennine Acute Hospitals NHS Trust (Oldham Hospital)
  • Southport and Ormskirk Hospital NHS Trust
  • University Hospitals of Morecambe Bay NHS Foundation Trust
  • Leeds Teaching Hospitals NHS Trust
  • Harrogate and District NHS Foundation Trust (Health Visiting Team)
  • County Durham and Darlington NHS Foundation Trust
  • The Newcastle on Tyne Hospitals NHS Foundation Trust
  • North Lincolnshire and Goole NHS Foundation Trust (based at Scunthorpe General)
  • Norfolk & Norwich University Hospitals NHS Foundation Trust
  • University Hospitals Coventry &Warwickshire NHS Trust
  • Derby Teaching Hospitals NHS Foundation Trust
  • Kettering General Hospital NHS Foundation Trust
  • University Hospitals of Leicester NHS Trust
  • Nottingham University Hospitals NHS Trust
  • Western Sussex Hospitals NHS Foundation Trust
  • Frimley Park Hospital NHS Foundation Trust
  • University Hospital Southampton NHS Foundation Trust
  • Royal United Hospitals Bath NHS Foundation Trust
  • Royal Cornwall Hospitals NHS Trust
  • North Middlesex University Hospital NHS Trust