Learning from deaths
Most people will be receiving care from the NHS at the time of their death and they experience excellent care from the NHS for the weeks, months and years leading up to their death. However, for some people, the experience is different and they experience poor quality services for a number of reasons, including system failure.
The right thing to do is review and investigate deaths where care and service delivery problems occurred so that we can learn and prevent recurrence.
We have developed a policy, learning from healthcare deaths – the right thing to do, which sets out how we will do this in line with our values.
When a death has been reported on the Trust incident reporting system, Datix, it will be reviewed by the patient safety support team in line with this flowchart.
Reported deaths
We publish cumulative data on learning from healthcare deaths on a quarterly basis, culminating in an annual report (to the end of quarter 4). The latest reports are available below:
- 2022/23 Learning from healthcare deaths report – cumulative report to end of quarter 3
- 2022/23 Learning from healthcare deaths report – cumulative report to end of quarter 2
- 2021/22 Learning from healthcare deaths report – cumulative report to end of quarter 4
- 2020/21 Learning from healthcare deaths report – cumulative report to end of quarter 4
- 2019/20 Final learning from healthcare deaths report – cumulative report to end of quarter 4
- 2018/19 Annual Learning from healthcare deaths report – cumulative report to end of quarter 4
- 2017/18 Learning from healthcare deaths report – cumulative report to end of quarter 4
Further work on themes is currently underway. Additional data is available in the Trust’s annual Quality Account report.
Support
Grief is a natural process, but it can be devastating. For those who need help, there are many sources of support available. We are currently developing further bereavement support resources.
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