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This is the first report published from the National Paediatric Mortality Register (NPMR) since it came under the governance of NOCA in 2020.The NPMR aims to collect, analyse and report on data relating to all deaths in children aged under 19 years in the Republic of Ireland. Although mortality in children has declined globally, many deaths continue to occur, and there is an urgent need to identify factors that contribute to those deaths so that appropriate intervention measures may be applied.
The purpose of this report is to provide an overview of child mortality and to demonstrate the need for a universal, centralised system for the notification of deaths that will permit analysis and timely reporting of data on child mortality. This report examines the data, which is currently available, and highlights the deficits in information at national level for 2019-2021.
All deaths in children and young people in Ireland should be notified as part of death certification to a central national database. The Department of Social Protection has commenced drafting legislation pertaining to death notification. The National Office of Clinical Audit (NOCA) recommends the completion of publication and enactment of legislation to mandate timely reporting of all deaths.
NOCA should work with the Health Service Executive (HSE) Office of the National Director Operations and Integration to ensure that the implementation of the proposed changes to the death notification process is aligned with the NPMR. This partnership should support the NPMR objective of implementing a universal, standardised system for capturing data on all CYP deaths in a national CYP mortality database.
The NPMR must have a universal and standardised death notification process that is designed to capture details of all deaths in children and young people nationally, including deaths occurring outside of hospital as well as in-hospital deaths. The dataset should be built in line with international best practice (e.g. including health equity stratifiers) and data must be received by NOCA in a timely fashion using electronic systems.
The proposed individual health identifier (IHI) should be utilised for the purpose of the NPMR in order to facilitate the national linkage of datasets. This will allow for an accurate assessment of the causes of CYP deaths by making essential information relating to underlying conditions and pre-existing comorbidities universally accessible.
In line with international best practice, NOCA should engage with the Department of Health and the HSE in order to advocate for the establishment of a national child mortality review panel. The independent review panel would examine childhood deaths, write reports and make recommendations relating to local and system-wide improvements or interventions aimed at reducing the number of childhood deaths.
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