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A review of each and every death in the Trust to ensure we have provided the highest quality of patient care or that lessons are learned and disseminated across the organisation if we have not.

Learning from the care provided to patients who die is a key part of clinical governance and quality improvement work (CQC 2016). In February 2017 the CQC set out new requirements for the investigation of deaths to run alongside the local existing processes.

The National Quality Board in March 2017 provided further guidance and recommendations for learning from deaths entitled ‘National Guidance For Learning From Deaths - A Framework for NHS Trusts and NHS Foundation Trusts on Identifying, Reporting, Investigating and Learning from Deaths in Care’.

The Trust has investigated deaths since 2012 through the use of a structured 2 stage independent peer review program, this policy updates and refines the existing procedures to ensure compliance with the above national guidance and improve the quality and objectivity of Mortality Review.

A peer review of each death in the Trust is required to ensure we have provided the highest quality of patient care or that lessons are learned and disseminated across the organisation if we have not.