SCOR - Standardised Clinical Outcome Review
SCOR is a web-based (NHS net) tool for comprehensive case review and action planning in response to perinatal deaths.
With the help of wide stakeholder involvement, we have recently developed a new
electronic tool (SCOR – Standardised Clinical Outcome Review) which helps clinicians
to review the circumstances preceding and surrounding their stillbirths and neonatal
deaths in a standardised way, and derive a taxonomy of substandard care factors
which can lead to a systematic action plan. This tool is currently being piloted
in 16 West Midlands units.
The findings of a series of regional perinatal confidential enquiries
wide variation of ways in which maternity units review and learn from such deaths.
With support by West Midlands Chief Executives and the SHA, the Perinatal Institute
started an initiative in 2010/11 to standardise the perinatal review process, and
convened a regional multidisciplinary working group to assist with this project.
The project aims to fulfil recommendations from Outcomes Framework for the NHS,
CNST requirements and the RCOG for the
development of a standardised review and reporting mechanism with performance management
tool to allow acute services and their commissioners to respond efficiently and
effectively to adverse outcomes.
- To provide a tool for standardised review of perinatal deaths
- To ascertain learning points and resultant actions to improve clinical practice
- To respond appropriately, ensuring that the such action points are implemented in
The process is supported by an electronic tool, which combines aspects of the confidential
enquiry proformas developed by the Perinatal Institute, and the principles of the
taxonomy developed by NPSA. SCOR (Standardised Clinical Outcome Review) assists
in-house teams with a methodological review of all relevant circumstances surrounding
a stillbirth or neonatal death.
The SCOR application incorporates the Perinatal Death Notification (PDN) as well
as sections on each aspect of perinatal care (e.g. antenatal, intrapartum, postnatal).
It is designed for completion by the clinical governance lead, on behalf of the
whole in-house perinatal mortality review team, who agree the standard of care and
overall avoidability grade. A case summary is generated on completion of SCOR which
includes Risk Factors, Key Points and Taxonomy (care issues). An Action Plan is
also incorporated, to support Trusts’ progress in addressing the identified
Peer Review Panel (PRP) is the main quality assurance part of SCOR; a key aspect of the review process to support robust and standardised assessment of cases across units.
Following regional consultative and training meetings, 6 West Midlands Trusts in September 2011 started to pilot the SCOR application. Since then 12 other units have requested to join the pilot across England and Scotland, including one in Canada.
Total Number of Cases Entered onto SCOR
Since the pilot commenced at the end of September 2011 and the end of November 2012, a total of 375 cases have been inputted.
For copies of the SCOR Pilot Update letters please click
For more information about SCOR or to discuss how SCOR could support the perinatal
death review process in your hospital, please contact Fiona Cross-Sudworth, Project
Manager or Professor Jason Gardosi, Project Lead.
Email: email@example.com; firstname.lastname@example.org
The NHS Litigation Authority (2011)Clinical Negligence Scheme for Trusts
Maternity Clinical Risk Management Standards Version 1 2011/12