Debate: Sepsis

This item was originally a Matter for Debate. This was changed to a resolution. The resolution was passed. 

Improving the identification and care of sepsis in children and young adults is a vital area for discussion.

Sepsis is identified as the body’s systemic inflammatory response to microbial infection, which may cause multi-organ damage, shock, and eventual death (UK Sepsis Trust, 2019). It can be extremely difficult for either the public or health care professionals to identify, with symptoms often suggesting other illnesses such as flu. Sepsis is known to be a global killer, and many survivors face the reality of living with its consequences for the rest of their lives.

In 2017, the UK Sepsis Trust estimated that sepsis affects 25,000 children a year in the UK. The annual cost of sepsis treatment in the NHS has been estimated at £15 billion. The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) estimate 200,000 annual cases of sepsis across the UK, with up to 60,000 deaths. Every four hours someone in Scotland dies of Sepsis – about 3,500 people in Scotland every year. According to Sepsis Northern Ireland, sepsis can affect around 7,000 people each year in Northern Ireland and is considered responsible for over 1,240 deaths. In Wales, there are estimates of 8,000 cases of sepsis with 2,500 deaths each year. There is no single solution that can unlock the improvements required in sepsis identification and care. We want to see changes in a number of areas within the UK, which support alignment in the care delivered for children and young adults with sepsis.

There is a national call and aim to achieve more consistent early identification and treatment of sepsis in children and young adults. It has been recognised that with a National Early Warning Score (NEWS2) patient care has improved. A uniformed UK-wide PEWS (Paediatric Early Warning Sign) score for children and young people would ensure improvements in identification and treatment of deterioration due to sepsis (NHS England, 2018). Scotland has adopted a PEWS regionally and seen care improve, however, in Northern Ireland, work to combat sepsis takes place at an Acute Care trust level and not across all regions.

There is a need for further work, providing considerable scope to improve survival and reduce long-term disability for patients, as well as an opportunity to significantly reduce health and social care costs.

Health care professionals play a key role in the identification and treatment of patients with sepsis. Across the UK it has been identified that nurses are a vital support for the education of patient, carers and families. To date, the Scottish Patient Safety Programme (SPSP) estimates that campaigns since 2012 have reduced mortality rates by 21% (SPSP, 2018). Work within Wales supported this by recommending moving the emphasis towards ensuring that as much as possible, nurses should be supported in the processes required for the recognition, escalation and treatment of acute deterioration (1000 lives, 2018). Therefore, we need to be aware of when an individual is particularly at risk of developing sepsis, and monitor for any signs or symptoms.