Changes to national mortality review committees, including FVDRC

Changes to national mortality review committees

The Health Quality & Safety Commission (HQSC) announced significant changes to the mortality review committees following an independent review. HQSC announced that a single national mortality review committee would be established next year to carry out the national mortality review function.

It also stated that the current mortality review committees would continue for now as expert groups, under the oversight of the new single National Mortality Review Committee.

Currently, there are five mortality review committees:

• Family Violence Death Review Committee (FVDRC)
• Perioperative Mortality Review Committee
• Perinatal & Maternal Mortality Review Committee
• Suicide Mortality Review Committee
• Child & Youth Mortality Review Committee.

HQSC has provided initial details about the planned changes, noting:

• a single National Mortality Review Committee will be established
• current mortality review committee members will be invited to become 'subject matter and representative experts' within the overall national mortality review function (NMRF)
• all current secretariat staff will transition to form part of the NMRF business unit
• data will be brought together under the NMRF
• statutory powers under Schedule 5 of the Pae Ora (Healthy Futures) Act 2022 will be transferred from the committees to the National Mortality Review Committee
• the single National Mortality Review Committee will be able to focus on 'current and emerging priority areas, informed by an all-mortality prioritisation process.'

HQSC outlined next steps:

"An interim National Mortality Review Committee will be stood up in early 2023 to provide expertise in the development of these core frameworks and identify emerging areas of mortality review.

The NMRF will continue to uphold key functions and activities of the existing MRCs, with a dual focus on reporting key mortality trends as well as assessing and prioritising areas of greatest need.

The interim National Mortality Review Committee and the Commission will work closely with the existing MRCs to transition institutional knowledge, and to ensure current members are well positioned to continue to provide an important voice as subject matter and representative experts.

Mortality review workstreams across child and youth, perinatal and maternal, and suicide will continue in the 2023/24 financial year under the transformed NMRF. A national expert group will continue to provide oversight and advice on national trends in perioperative deaths. Family violence death review will remain in place for the long term." [emphasis added]

In the media release, HQSC board chair Dr Dale Bramley said

"All current committees will continue to exist until 30 June 2023, throughout the transition to the refreshed model, and members will be invited to become subject matter and representative experts within these priority workstreams of the National Mortality Review Committee. I can assure current committee members that their areas of focus will continue to be a priority throughout the transition."

Dr Bramley also said "One of the main reasons for the transformation is to address inequities in Māori mortality rates."

The changes are based on an independent review of the national mortality review function completed by Francis Health in April 2022.

The Final report: Review of the national mortality review function (March 2022) summarises the review findings and recommendations. The report highlighted "the vital importance and value of a mortality review function" but also highlighted areas to improve function and impact. Key areas of change included Te Tiriti compliance, expansion of scope, and increased attention on cross-sector engagement, among others.

Update: Two appendices from the final review report are available: Appendix A: Current state critical review and Appendix B: Literature review.

Further details are not yet available about what the changes will mean for the function, statutory powers, and committee members of the Family Violence Death Review Committee.

For questions about the independent review or the new National Mortality Review Function email: mrcsecretariat@hqsc.govt.nz.

Update: The changes to the national mortality review function came into effect on 1 July 2023. Details about the new National Mortality Review Committee, committee member bios, and subject matter experts are available on the Te Tāhū Hauora Health | Quality & Safety Commission website. Fiona Cram, current chair of the Family Violence Death Review Committee and Ngā Pou Arawhenua (Māori caucus of the current mortality review committees), is one of 8 members on the new National Committee. There are 5 initial workstreams for the new National Mortality Review Committee - this includes a Family violence death review workstream to build on the work of the previous Family Violence Death Review Committee.

Background on the Family Violence Death Review Committee

The Family Violence Death Review Committee (FVDRC) was established in 2008 as an interagency, multi-disciplinary committee to systematically review all family violence deaths, as an initiative launched by the Taskforce for Action on Violence within Families.

In 2010, the Health Quality & Safety Commission was set up as a Crown entity and took responsibility for national mortality review committees, including the FVDRC. The FVDRC became a statutory committee under Section 59E of the amended New Zealand Public Health and Disability Act in April 2011. Currently, the FVDRC reports to the Health Quality & Safety Commission Board, and through the Board, to the Associate Minister of Health.

The final report from the review of the national mortality review function highlighted that:

"The methodology and review model developed and applied by the current FVDRC provides a benchmark for taking a holistic and whole of system approach. This model takes a life course approach and allows an intensive and multi sectoral review which yields insights with broad applicability and relevance."

The report also highlighted that "the FVDRC is the only MRC [mortality review committee] which has been able to build a critical mass of Māori expertise."

See the article, Getting the Story Right: Reflecting on an Indigenous Rubric to Guide the Interpretation of Mortality Data, for information about how the FVDRC addresses tikanga-based principles in their reviews and reports.

The FVDRC's seventh report, A duty to care | Me manaaki te tangata, has more information about the FVDRC and how the committee functions.

Update: Also see the recently published article Te Pou: An Indigenous Framework to Evaluate the Inclusion of Family Voice in Family Violence Homicide Reviews (2022). The article evaluates the inclusion of family and whānau voice in the indepth review process of the Family Violence Death Review Committee in Aotearoa New Zealand.  

Also see the HQSC website for information on the Family Violence Death Review Committee.

Related media

Mortality review shake-up allows Māori focus, Waatea News, 03.07.2023