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Tieng Anh Vui
More must be done to save the lives of patients with sepsis, says a report from the Health Service Ombudsman.
It found significant failings in the diagnosis and treatment of the potentially fatal condition.
The report focused on 10 patients who were not treated urgently enough and died.
The National Institute for Health and Care Excellence will produce guidance for GPs and clinicians to help them recognise sepsis at an early stage.
'Sepsis was taking over his body'
Jem Abbotts was 37 years old and recovering from a routine operation when he became ill.
He started vomiting and feeling feverish so the GP prescribed antibiotics and he went to bed to recover.
But a few days later he woke up vomiting and was rushed to hospital in a coma, as his organs began to fail.
He had contracted a bacterial infection which had entered his bloodstream, causing a condition known as sepsis.
The Ombudsman, who investigates complaints from people who have received poor service from the NHS in England, said diagnosing and treating sepsis presented some real problems because it was hard to spot and hard to treat.
Sepsis is caused when the body's immune system overreacts to infection. It can lead to swelling and blood clotting - and cause internal organs to stop working.
The most common causes of severe sepsis are pneumonia, bowel perforation, urinary infection, and severe skin infections.
Julie Mellor, the Health Service Ombudsman, said it was time for the NHS to act.
"In the cases in our report, sadly, all patients died. In some of these cases, with better care and treatment, they may have survived.
"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."
The report recommended improving the recognition and treatment of sepsis by providing medical staff with clear clinical guidance.
She also recommended that NHS England launch a public awareness campaign which targets vulnerable groups of patients, such as those who are weak or in hospital.
Clinical staff should attach more importance to listening to the relatives of patients since they can be the first to recognise the patient's deterioration, she said, and more senior doctors should be involved in patient care.
According to the UK Sepsis Trust, around 37,000 people are estimated to die of sepsis each year, accounting for 100,000 hospital admissions.
Simple life-savers
Dr Ron Daniels, chairman of the UK Sepsis Trust, said there was a straightforward solution.
Facts about sepsis
- Sepsis is a more common reason for hospital admission than heart attack - and has a higher mortality.
- The most common causes of severe sepsis are pneumonia, bowel perforation, urinary infection, and severe skin infections.
- The most common signs of sepsis are a high fever, violent shivering, fainting, cold and pale hands, rapid breathing, confusion or delirium.
- 37,000 people are estimated to die of sepsis each year in the UK.
- From the time sepsis first takes hold, healthcare workers have just hours to deliver the right care.
"The best hospitals have achieved better outcomes from sepsis by adopting a simple set of life-saving measures, collectively known as the Sepsis 6, and ensuring that a culture of awareness around sepsis has been created.
"We now need to spread this awareness to other health professionals and to the public, and to underpin this with guidance from NHS England and the National Institute for Health and Care Excellence."
He said the recommendations would potentially save 12,500 more lives every year.
Dr Mike Durkin, NHS England's director of patient safety, said the NHS would use the findings to work with GPs and hospitals to reduce deaths from sepsis.
"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."
Dr Peter Carter, chief executive of the Royal College of Nursing, said the report showed the tragic consequences of sepsis.
"It is vital that all staff are provided with training and support to enable them to recognise the signs and symptoms of sepsis, and crucially to know how to act quickly when sepsis is diagnosed."
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