New national data demonstrates significant reductions in regional infant mortality rates.

New findings published by the National Child Mortality Database (NCMD) at the University of Bristol provide an important opportunity to recognise major progress in outcomes for premature infants and their families across England. The NCMD’s annual data release for the year ending 31 March 2026 reveals that infant mortality in some of England’s most disadvantaged areas fell by 16% compared with the previous year.

Nationally, total child mortality (aged 0–17) fell by 8% to 3,223 cases - the lowest level recorded since 2020–21 - with infant mortality (under 1 year of age) falling by 7%, lowering the national infant mortality rate from 3.8 to 3.5 per 1,000 live births. Neonatal outcomes accounted for 44% of total child mortality, while overall infant outcomes accounted for 61%.

The largest regional reductions in infant mortality rates were observed in areas implementing the PERIPrem (Perinatal Excellence to Reduce Injury in Premature Birth) care bundle:

• South West: 23% reduction in infant mortality rate (where PERIPrem was co-produced and first implemented in 2020 by Health Innovation West of England and Health Innovation South West in partnership with the South West Neonatal Operational Delivery Network).
• West Midlands: 18% reduction in infant mortality rate (following rollout in partnership with the NHS England Midlands Perinatal Team across all regional units in January 2025 by Health Innovation West Midlands).
• East Midlands: 16% reduction in infant mortality rate (following rollout in partnership with the NHS England Midlands Perinatal Team across all regional units in January 2025 by Health Innovation East Midlands).

The NCMD report highlights that these regional improvements coincided directly with the implementation of the PERIPrem perinatal care bundle.

A collaborative approach to tackling the challenges of prematurity

Babies born prematurely face high risks of neurological complications, long-term developmental disorders, and mortality. Brain injury caused by prematurity represents the single largest cause of cerebral palsy, and prematurity remains the leading cause of infant mortality in England.

PERIPrem is a bundle of evidence-based clinical interventions designed to optimise outcomes for premature infants. It was originally co-produced and implemented across 12 NHS trusts through a partnership between the South West Neonatal Operational Delivery Network (ODN), Health Innovation West of England, Health Innovation South West, and multidisciplinary clinical teams.

The model combines clinical leadership, improvement support, and timely data to help teams embed best practice reliably. The programme has since spread beyond the South West to Wales, the East Midlands and the West Midlands, demonstrating the wider value of this collaborative model.

Karen Luyt, Programme Director for the National Child Mortality Database, Professor of Neonatal Medicine at the University of Bristol, and Healthier Childhoods lead at NIHR ARC South West, said: “Prematurity remains a leading contributor to deaths in the first year of life. The NCMD thematic report on Newborn Health recommended the universal implementation of the PERIPrem care bundle in areas of England with high infant mortality.

In January 2025, NHS England Midlands Perinatal Team and the health innovation network for the East Midlands and West Midlands funded the rollout of PERIPrem across all perinatal units serving their respective populations. This built on the work in the South West, where PERIPrem was co-produced and first implemented in 2020. The substantial reduction in infant mortality in West and East Midlands highlights the utility of investment in universal support of every maternity and neonatal unit to accelerate implementation of effective interventions to optimise outcomes after preterm birth.

Structured quality improvement and evidence of impact

PERIPrem extends beyond a standard clinical care bundle; it is a structured improvement model that brings together ODNs, health innovation networks and multidisciplinary perinatal teams, supported by dedicated funding, protected clinical leadership time, quality improvement expertise, and timely data. Independent research has shown that PERIPrem improves the implementation of evidence-based care and strengthens collaboration, communication and team culture across perinatal services.

Key dimensions of evidence and impact include:

• Improved implementation of evidence-based care: the original evaluation reported significant improvements in the delivery of individual PERIPrem interventions and an increase in the proportion of eligible mothers and babies receiving the interventions for which they were eligible. Reliable implementation is an essential route between clinical evidence and improved outcomes.
• Stronger perinatal teamwork: implementation research found benefits beyond individual care interventions. PERIPrem strengthened collaboration, communication, shared ownership, and team culture across perinatal services. This coordinated action across the whole pathway is essential for effective perinatal optimisation.
• Clinical and audit outcomes: national NNAP reporting has highlighted consistently strong neonatal outcomes across the West and South West of England, including performance on mortality, preterm brain injury, delayed cord clamping, and early breastmilk measures.
• Verified regional mortality reductions: official NCMD findings confirm substantial regional drops in infant mortality coinciding with PERIPrem implementation, led by a 23% fall in the South West, 18% in the West Midlands, and 16% in the East Midlands.
• Equality and reducing variation: PERIPrem supports equity by increasing the reliability of evidence-based care and reducing unwarranted variation between services. A consistent regional approach, common standards and routine feedback help teams identify where eligible mothers and babies are not receiving the same care as others.

The key question for policymakers, commissioners and clinical leaders is not whether PERIPrem alone caused these improvements, but whether the combination of strong ODN leadership, health innovation network support, multidisciplinary perinatal teamwork, improvement expertise and meaningful data is helping create the conditions needed for better outcomes.

As health systems seek to reduce variation and improve outcomes for babies born prematurely, PERIPrem offers a practical, evidence-informed model that could help accelerate improvement elsewhere.

Further information

Read the full report on the NCMD website.

Read the NCMD press release issued by the University of Bristol.

Find out more about the PERIPrem programme.