NHS England is working with partners to take action to improve the identification, diagnosis and management of sepsis and to support healthcare professionals to recognise and treat sepsis promptly.
What is sepsis?
Sepsis is a common and potentially life-threatening condition. Without early identification and treatment there is a significant risk of long term disability or death.
Anyone, at any age can develop sepsis after an injury or minor infection, although some people are at higher risk such as those with a weakened immune system, a serious illness, the very young or very old, or those who have just had surgery.
Sepsis can be extremely difficult to recognise and diagnose, but sometimes it can be prevented, and it is treatable in many cases.
Why must we take action?
The number of people developing sepsis is increasing. The UK Sepsis Trust estimate that in the UK, i) about 147,000 people are admitted to hospital with sepsis every year: 137,000 adults and 10,000 children ii) that 30 per cent of the people admitted to hospital with sepsis die, so around 44,100 deaths are attributed to sepsis every year. The estimated annual cost of sepsis in the UK is around £7.42 billion at the most conservative end of the spectrum, and may be as high as £10.2 billion.
If we can achieve more consistent early identification and treatment of sepsis there is considerable scope to improve survival and reduce long term disability for patients as well as an opportunity to reduce healthcare costs.
The Suspicion of Sepsis (SoS) Insight Dashboard
The SoS Insight Dashboard launched in September 2018. It was created by Imperial College Health Partners (ICHP) through the Patient Safety Collaborative, in collaboration with NHS England and NHS Improvement, and building on the methodology for measuring sepsis previously published by Oxford Academic Health Science Network.
It is a tool that accurately measures the number of patients admitted to hospital who are at risk of sepsis. It will enable the NHS to track improvement, such as rates of survival and length of hospital stays through measuring the number of patients coming into hospital as an emergency with a severe bacterial infection categorised as ‘suspicion of sepsis’. Previously the measurement for sepsis has fluctuated but this tool gives serious infections a defined category that all organisations in the NHS will use, identifying patients who should be screened for sepsis and giving clinicians the most accurate picture yet for how many people are at risk of developing sepsis.
Cross System Sepsis Programme Board
NHS England is part of a Cross-System Sepsis Programme Board that brings together a group of experts from across the health and care system, to take action to improve the identification, diagnosis and management of sepsis in children, young people and adults across the NHS.
This 2017 Action Plan brings together the work on sepsis that is being taken forward nationally in the NHS in England. The over-arching purpose is to improve the prevention, early diagnosis and prompt treatment of sepsis in order to reduce the mortality and morbidity that it causes. Members of the Cross-System Sepsis Board have committed to deliver these actions in a coordinated and aligned manner.
National Early Warning Score (NEWS)
A National Early Warning Score NEWS was developed by the Royal College of Physicians (RCP) in 2012 to standardise the process of recording, scoring and responding to changes in routinely measured physiological parameters in acutely ill patients.
In December 2017, an updated version of NEWS, NEWS2 was published. It contains welcome improvements on the previous version of NEWS. For example, the chronic hypoxia sub chart helps to better tailor escalation to baseline oxygen levels in those with respiratory disease. It also includes the addition of delirium to the consciousness sub chart, and the reinforcement of the value of aggregate scores versus single parameter extreme recordings.
NEWS2 has received formal endorsement from NHS England and NHS Improvement to become the early warning system for identifying acutely ill patients. However, the National Quality Board and NICE have recommended further evaluation of the use of NEWS in a community setting including primary care. NHS England is therefore working alongside partners to collate robust evidence on the use of NEWS2 in community and primary care.