Saving Mothers' Lives: - Public Health Agency for Northern Ireland

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APPENDIX 1: Method of Enquiry
section. Although each pregnancy-associated-maternal-death reported to this Enquiry is only counted once
and assigned to one chapter, it may be referred to in additional chapters. For example, a death assigned to
“hypertensive disorder of pregnancy”, in which haemorrhage and anaesthesia also played a part, may be
discussed in all three chapters.
Authors
Chapters are initially drafted by individual Central Assessors, and then discussed in detail by the whole
panel before the Report is fi nalised. Other acknowledged professionals who have a particular and
expert interest in specifi c diseases or areas of practice may be asked to review and comment on the
recommendations prior to publication.
Statistical analysis and data presentation advice to each author is provided by both an independent
statistical advisor, and data analysts at CEMACH.
Confi dentiality
After preparation of the Report, and before its publication, all maternal death report forms, related
documents and fi les relating to the period of the Report are destroyed, and all electronic data are
irreversibly anonymised.
Denominator Data
Denominator data and other relevant statistical data are supplied by organisations such as ONS, the
Scotland General Registrar Offi ce (GRO), Northern Ireland Statistical Research Agency (NISRA) and
Hospital Episode Statistics (HES).
Northern Ireland
In Northern Ireland the same government requirement applies, in that all maternal deaths should be
subject to Confi dential Enquiry. During this triennium the responsibility for initiating an enquiry remained
with the Director of Public Health (DPH) of the health and social services board in which the woman
was resident. Maternal deaths were reported to the relevant DPH, who was responsible for organising
completion of the MDR-1 by those involved in the care of the dead woman, and obtaining the autopsy
report, where one had been conducted. On completion, the forms were sent to the Medical Coordinator at
the Department of Health, Social Sciences, and Public Safety. The Medical Coordinator, acting on behalf
of the Chief Medical Offi cer, anonymised the forms, and then coordinated the input of the pathology,
anaesthetic, midwifery and obstetric assessors. A single panel of assessors dealt with all cases. Assessed
MDR-1 forms, and other collected documentation, were forwarded to the CEMACH Central Offi ce and
submitted to the MDE Director for central assessment, as outlined for England and Wales, and illustrated in
fi gure 1. All data and databases are held in accordance with CEMACH’s information security procedures
as for England and Wales.
Ascertainment is checked with reference to data supplied by the General Registrar’s Offi ce in Northern Ireland.
From 2006 the notifi cation is made directly to the CEMACH Regional Manager, who initiates the enquiry on
behalf of the DPH and, in conjunction with CEMACH Unit Co-ordinators and professional staff, arranges for
completion of the MDR-1 form. The same process of anonymisation and regional assessment is followed
as before.