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New action plan to help tackle ‘silent killer’ sepsis

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A new action plan has been published today by NHS England to help support healthcare professionals to recognise and treat sepsis promptly.

The number of people developing sepsis is increasing, with around 123,000 cases each year in England. An estimated 37,000 deaths are associated with the condition.

“We need to ensure that healthcare professionals are supported and equipped to identify and treat sepsis early”

Bruce Keogh

A recent report from the National Confidential Enquiry into Patient Outcome and Death found only a third of sepsis patients received good quality care and a sepsis charity has estimated that 10,000 deaths could be avoided each year through better prevention, early diagnosis and treatment.

NHS England noted that sepsis was known as a silent killer and could be extremely difficult to recognise and diagnose, but sometimes could be prevented and was treatable in many cases.

Earlier this year, it said it brought together royal colleges, the UK Sepsis Trust and others to advise on how best to improve the recognition and treatment of the condition.

The resulting five-point plan sets out what is needed to drive improvements for patients with sepsis, identifying and focusing on key areas.

One of these areas is preventing avoidable cases of sepsis. NHS England said some cases were preventable, particularly in at-risk groups including older people, the immunosuppressed, pregnant women and children.

In order to support this, the plan said NHS England, Care England and the National Care Forum would gather examples of best practice in care home sector with regards to urinary tract infections and sepsis, and share the learning.

It also noted that NHS England had published a continence framework outlining good practice, which can help to reduce the onset of UTIs – a major source of sepsis.

Another key area cited by NHS England was increasing awareness of sepsis among both the public and professionals, as treatment is extremely time sensitive.

Actions include the UK Sepsis Trust developing “sepsis savvy” microteaching sessions for parents and others to raise awareness, communication and social media outreach.

Public Health England is also assessing the evidence base for a public awareness campaign on sepsis.

Meanwhile, the plan highlighted the need to improve identification and treatment of sepsis across “whole care pathway”.

It said improvements were needed to ensure that patients received the care they need “irrespective of the first point of contact” with health services.

“Our focus is on early detection, getting patients the right treatment at the right time, and involving senior staff quickly when patients deteriorate”

Celia Ingham Clark

Actions will include the Care Quality Commission looking at how trusts are using evidence-based guidelines once the National Institute for Health and Care Excellence has published guidance in 2016.

The need to improve consistency of standards and reporting was highlighted by the plan.

Much more robust information was needed on the true prevalence and associated burden of sepsis to inform future quality improvement initiatives, it said.

This will be partially covered by the new NICE clinical guideline in 2016 and also by a quality standard due in 2017.

In addition, the Health and Social Care Information Centre will produce SNOMED code sets representing the standard/acceptable clinical phrases for sepsis following publication of new international definitions of sepsis.

keogh bruce1

Bruce Keogh

Lastly, NHS England said ensuring appropriate antibiotic prescribing was “imperative”. As evidence about the effectiveness of antibiotics in treating severe sepsis becomes clearer, it said organisations will look to refresh guidelines on antibiotic use to represent up to date, robust evidence.

Professor Sir Bruce Keogh, NHS England’s medical director, said: “What is clear is that we all want to do better for this group of patients.

“In many cases sepsis is avoidable, and if not, it is often treatable, so we need to ensure that healthcare professionals are supported and equipped to identify and treat sepsis early,” he said.

“We have a good idea of what needs to be done and this plan aims to make things happen,” he added.

Celia Ingham Clark, NHS England’s national director for reducing premature deaths, said: “As well as the publication of this action plan, we also have an ongoing programme to help educate clinicians around the early recognition and treatment of sepsis.

“Our focus is on early detection, getting patients the right treatment at the right time, and involving senior staff quickly when patients deteriorate, all of which will improve their chances of making a full recovery,” she said.

In addition, a patient safety alert has been issued to highlight resources such as the “sepsis six” and ensure all NHS providers in England are aware of them.

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