July 16, 2019

Sepsis: how are hospitals faring in the fight against this ‘hidden killer’?

NHS England has reported that performance is improving when treating patients within one hour of being diagnosed with suspected Sepsis. However according to research carried out by BBC News a quarter of patients in England wait longer to receive intravenous antibiotics.

What is sepsis?

Sepsis, an infection which causes your immune system to go into overdrive, is known as the ‘hidden killer.’ It is difficult to spot although guidance has since been provided to list the symptoms of sepsis you would need to look out for including muscle pain, breathlessness and skin mottled or discoloured.

Early intervention and management within the hour is key to ensuring the infection does not spread and result in organ failure or even death. There are many cases where delay in treatment has resulted in the death of a patient which was completely avoidable had antibiotics been administered earlier.

I too am familiar with the infection having suffered from it a couple years ago. Fortunately for me I recovered, but there are many who have not survived this life-threatening infection.

How are good are hospitals at treating the condition?

Over the past three years, hospitals in England have had to report how well they are identifying and treating sepsis.  As an incentive to take part and improve the reporting, a small part of their budget (less than 1%) has been held back.

Amongst the reported figures are those showing how quickly antibiotics are given when sepsis is suspected.

Unfortunately, it has been reported by the BBC that although approximately 75% of patients with suspected sepsis between January and March of this year did receive treatment within an hour, 25% did not and, there was a lot of variation between different trusts with several failing to treat the majority of patients within the one hour guideline timescale.

Could there be a reason for the delays?

Whilst it is very concerning to hear that hospital trusts are failing to meet the guideline recommendations for the provision of antibiotics, there may be an explanation as to why some patients are not treated within the hour.  It could be that medical staff are waiting for the results of tests to ascertain if a patient is indeed suffering with sepsis before treatment is started or there may be concern regarding the correct antibiotics to give or patients may be allergic to certain medications.

Whatever the reason it is clear that further improvement may be required to ensure that any patient with suspected sepsis is treated in a timely manner to prevent an adverse outcome.

What more can be done?

According to The UK Sepsis Trust, Sepsis currently claims 52,000 lives a year in the UK. The charity has developed something known as the ‘Sepsis Six’ which has been shown to reduce the risk of death by 46.6% when delivered to patients within one hour of being diagnosed with Sepsis. It provides a set of six tasks including oxygen, cultures, antibiotics, lactate measurement and urine output monitoring.

There is also the National Early Warning Score (NEWS) which was developed by the Royal College of Physicians. Its aim is to improve the assessment and response to adult patients who are clinically deteriorating including those with Sepsis. NEWS2 is the updated version of NEWS and has received formal endorsement from NHS England and NHS Improvement.

The long-term plan for treating sepsis on the NHS

Celia Ingham Clark, medical director for clinical effectiveness at NHS England has previously stated,

“We’ve come a long way in the NHS in improving how we identify and tackle sepsis, with more people having the problem spotted and treated than ever before. The NHS long term plan is a blueprint for transforming NHS care and after the success we’ve had ramping up earlier sepsis diagnosis in many parts of the country, all hospitals will now be required to deliver the best possible practices for identifying and treating sepsis.”

I would hope that one day we can say sepsis is no longer one of the biggest, or ‘hidden’, killers in the UK.

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