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World Sepsis Day: Four years on from our Time to Act report, what has changed?

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Lead clinician

Today (13 September) is World Sepsis Day, a day when people around the globe come together to raise awareness of sepsis. This month also marks four years since our “Time to Act” report which made recommendations for faster diagnosis and treatment of sepsis that could save thousands of lives.

In this blog, I look back on what’s changed since the report was published and what still needs to be to done to win the fight against sepsis.

What is sepsis?

Sepsis occurs when multi-organ failure develops as a result of tissue damage caused by the body’s response to an infection. A sepsis infection is very common but severe sepsis is a rare complication.

The infection can spread rapidly and can be hard to detect and diagnose. Severe sepsis causes around 44,000 deaths a year in the UK, a third of which are avoidable.

Learning from our casework

For our report, we reviewed 120 cases and picked out 10 tragic fatal cases that had important lessons to improve the diagnosis and treatment of sepsis. 

Our casework revealed:

  • inadequate clinical assessment
  • delayed recognition
  • inadequate monitoring
  • lack of attention to abnormal blood test results
  • delayed treatment including intravenous fluids, antibiotics and surgery
  • lack of timely involvement of senior doctors
  • lack of timely referral to critical care
  • inadequate monitoring after admission to hospital.

Progress on improving outcomes for people with sepsis

Our Time to Act report helped put sepsis awareness on the national health agenda and prompted actions to improve outcomes for people with sepsis, including:

  • new education and training materials to increase awareness of sepsis among healthcare professionals
  • a national campaign spearheaded by Public Health England and the UK Sepsis Trust to raise awareness of sepsis among parents and carers of young children.

The National Institute for Health and Care Excellence also produced a guideline last year to help NHS staff recognise and treat this life threatening condition more quickly, and have published a new quality standard today, setting out priorities for treating cases of sepsis.

Health Secretary Jeremy Hunt has also announced a new NHS plan today to improve treatment of the sepsis. Thousands of nurses, care home staff and pharmacists will be told how to check for signs and symptoms of the infection.

Some NHS hospitals are still missing the treatment target

More recent developments show that progress, while promising, has been too slow.

The Royal College of Emergency Medicine’s May 2017 audit of sepsis care shows that around half of patients with sepsis do not receive life-saving antibiotics early enough.

While there have been improvements in healthcare staff taking observations and involving senior consultants in good time, this still only happens in about two thirds of cases.

Worryingly, data obtained by BBC Panorama shows that people’s chances of surviving sepsis can depend on where they live, with some NHS hospitals still missing the treatment target.

Figures from 104 trusts suggest 37% of patients that need antibiotics for sepsis do not get them within an hour, and 14 hospital trusts are only screening one in every two people with signs of sepsis. 

More must be done to fight sepsis                                            

We are still seeing far too many people losing their loved ones to sepsis due to delays and missed warning signs. Last year the Ombudsman received 62 complaints and completed 76 investigations into failings in care of people with sepsis.

We need to keep raising awareness of the dangers and symptoms of sepsis so that everyone knows what to look out for. This is especially important for parents of young children.

More lives can be saved, and health professionals across the NHS must continue to work to improve diagnosis and provide rapid treatment of sepsis to achieve this.

Find out more about World Sepsis Day.

Visit the UK Sepsis Trust website for more information about sepsis.