More must be done to help sepsis patients, according to a new report.
A study by the Health Service Ombudsman found shortcomings in initial assessment and delay in emergency treatment which have led to missed opportunities to save lives.
The report, published to mark World Sepsis Day, focused on 10 cases investigated by the Ombudsman where patients did not receive the treatment they urgently needed - and in every case died.
It found that care failings seem to occur mainly in the first few hours after arrival in hospital, when rapid diagnosis and simple treatment can be critical to the chances of survival.
Recurring shortcomings included lack of timely history and examination on presentation, failure to recognise the severity of the illness, delays in administering treatment, and delay in source control of infection.
Health Service Ombudsman Julie Mellor said: “In the cases in our report, sadly, all patients died. In some of these cases, with better care and treatment, they may have survived. It is time for the NHS to act to save lives by improving the care of patients with sepsis.
“We have worked closely with NHS England, NICE, UK Sepsis Trust and royal colleges to find solutions to the issues identified in our report. NICE and NHS England have already agreed to take forward the recommendations of our report. We know it is not easy to spot the early signs of sepsis, but if we learn from these complaints and work to improve diagnosis and provide rapid treatment, then lives can be saved.”
Sepsis is an overreaction to infection by the body’s immune system, which can lead to widespread inflammation (swelling) and blood clotting.
It accounts for 100,000 hospital admissions each year, with an average cost of about £20,000 each, according to the UK Sepsis Trust. Around 37,000 people are estimated to die of it each year.
The most common causes of severe sepsis are pneumonia, bowel perforation, urinary infection, and severe skin infections.
The Ombudsman’s recommendations include improving recognition of sepsis, as well as treatment, and improvements in auditing and research.
NHS England’s director of patient safety, Dr Mike Durkin, said: “This report is timely and effective in bringing to everyone’s attention the importance of this condition and the impact it has on our patients. We will use its findings to work with general practitioners and hospitals to reduce the 37,000 deaths that occur each year due to sepsis.
“The patient safety domain within NHS England has many work programmes under way and this report and guidance will help us to build on the work that is already in place to emphasise the importance of education, early detection and prompt treatment.
“We all need in every setting to understand the importance of identifying deterioration in both adults and children, in reducing the admission of full-term babies to neonatal care and identifying problems in vulnerable older people in the first 48 hours of acute illness.
“By working with partner organisations, both within the NHS and the wider health community, NHS England will continue to give tackling sepsis the priority it deserves.”
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