Spotlight on sepsis

Sepsis is a condition that many doctors dread, with the common symptoms the condition presents making a firm diagnosis a challenge. To support clinicians, Health Education England has launched Think Sepsis – a new education programme. We turn the spotlight on sepsis and look at what resources are available to support practices

Every year over 120,000 people become infected with sepsis, with 37,000 of those dying from the condition. Sepsis is also known as blood poisoning or septicaemia and is a serious, and potentially life-threatening, complication of an infection where the body starts to attack itself, targeting tissues and organs. The symptoms include cold hands and feet, mottled skin, an increased heart and confusion. Prompt diagnosis and treatment can save lives but, sadly, even today sepsis is often misdiagnosed or discovered too late.

It’s an emotive issue, one which saw Matthew Hancock, health and social care secretary, become embroiled in a very public social media spat. While his words could have been better chosen, his commitment to tackling sepsis is encouraging for all of those within the health service who have seen the damage it can wreak.

Sepsis kills over 52,000 every year – each death a preventable tragedy. So we’re introducing new guidance to use #data to identify & treat sepsis faster – and save more lives https://t.co/Uh7dz4l0Wj

— Matt Hancock (@MattHancock) March 11, 2019

To support clinicians in more effective identification of sepsis, and to ensure that treatment is commenced as quickly as possible, Heath Education England has created Think Sepsis, an e-learning training package for clinicians. Approximately 70% of all sepsis cases develop within primary care, which is why awareness, and an understanding of the condition, is so important. The RCGP estimates that up to 10,000 lives could be saved each year by more prompt diagnosis and treatment.

Based on the 2016 NICE Guidelines, Sepsis: recognition, diagnosis and early management, the Think Sepsis module has five parts:

Session 1 – Overview of Sepsis

Session 2 – Adult Sepsis

Session 3 – Childhood Sepsis

Session 4 – Complex Sepsis Issues and Future Development

Session 5 – Sepsis, Care Homes and the Frail Elderly

Together, the resource provides a complete overview of what sepsis is, its symptoms and how to correctly identify them. It explores, in detail, sepsis in children, adults and the elderly. The short sessions build to provide a comprehensive overview that will benefit all clinicians.

You can access the training package through your e-LfH account. It is also available to NHS healthcare staff via the Electronic Staff Record (ESR); accessing this e-learning via ESR means that your completions will transfer with you throughout your NHS career.

Practice lead – ten top tips

The RCGP has produced its own set of clinical resources that can be accessed by practices; they can raise awareness of what sepsis is and its importance, which can help to improve care.

As part of an NHS focus on sepsis, every practice should now have an identified sepsis lead, charged with ensuring that all staff are aware of sepsis. The practice lead is responsible for assuring CCGs that sepsis awareness and care is considered at all times.

The sepsis lead role can be challenge, with some expressing confusion at what the expectations are. To help support practice leads, and clarify expectation, the RCGP has created Ten Top tips for sepsis leads in general practice. A general practice sepsis lead should:

1. Be a senior member of the practice team (either clinical or non-clinical).
2. Undertake other roles related to infection prevention control and antimicrobial stewardship as is appropriate.
3. Ensure that all members of staff in the practice under take sepsis learning appropriate to their role.
4. Ensure that appropriate sepsis and infection control messages are visible in the practice.
5. Support and monitor the use of physiology in the assessment of patients with infection and in the communication of concern to hospital and ambulance services.
6. Promote the use of safety netting leaflets for patients within the practice.
7. Promote the appropriate vaccination of staff and patients, particularly vulnerable groups, against in influenza and other relevant infections.
8. Promote and audit antimicrobial prescribing to safeguard against resistance and adverse effects from unrequired medication.
9. Develop systems to capture and review sepsis cases within the practice population.
10. Lead practice response to any outcomes from such review processes as are undertaken either within the practice or locality.

New developments

Across the NHS there is great work aimed at improving sepsis awareness, diagnosis and treatment. In one exciting development the West of England Academic Health Science Network (WEAHSN) has been working with all acute trusts, out-of-hours GP services, mental health trusts, community service providers and clinical commissioning groups in the west of England to implement an early-warning score system. This is helping to improve the way sepsis is managed, as this short film demonstrates:

If identified early, sepsis can be treated effectively with patients often making a full recovery. Together the NHS is taking action on sepsis to improve the way the condition is diagnosed and treated.  New developments like the HEE training package and process improvements like the WEAHSN early warning score are helping to strengthen the approach.

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