The Perinatal Institute has developed the GAP-SCORE (Standardised Case Outcome Review and Evaluation) audit tool which aims to assist clinicians in reviewing clinical care in the ‘missed case’ of fetal growth restriction. From risk assessment at the beginning of pregnancy and care pathways throughout pregnancy, the care is reviewed in a standardised way. The software guides clinicians through the review process by examining potential factors which may have improved the referral rate for suspicion and detection of fetal growth restriction.

The aims of the audit are:

• - To potentially identify why the fetal growth restriction was missed
• - To identify if there are any training issues
• - To identify any themes/system failures
• - To focus service provision
• - To provide evidence for commissioning support/services within Trusts

The audit uses the NHS England Saving Babies’ Lives. Reduction of stillbirths care bundle (element 2) algorithm for identification of increased and low risk pregnancies: www.perinatal.org.uk/images/care_bundle_algorithm.png

Disclaimer for GAP-SCORE:
This tool is not designed to audit care following a stillbirth or neonatal death. A full clinical review of care provision is required as this is an adverse outcome. GAP SCORE is aimed at the ‘missed case’ of fetal growth restriction only.