Patients with sepsis: a review of care

Sepsis is a major cause of avoidable mortality and morbidity and is an issue that, in recent years, has received increased focus from health and political organisations. NHS England has identified tackling sepsis as a clinical priority for improving patient outcomes for 2015/161 and it has been linked to a new CQUIN in England.2 The National Institute for Health and Care Excellence (NICE) is also in the process of developing sepsis guidelines.3 

In 2013 the Parliamentary and Health service Ombudsman published her first clinical report ‘Time to Act’, identifying common themes in ten case studies of patients who died following sepsis.4 This report identified failings throughout the patient pathway – from carrying out a timely initial assessment and identifying the source of infection to adequate monitoring and timely initiation of treatment. In 2013 the All Party Parliamentary Group (APPG) on sepsis was also formed, which has recently published ten recommendations in a report,5 highlighting similar themes to those presented in the most recent National Confidential Enquiry into Patient Outcome and Death (NCEPOD) report, ‘Just Say Sepsis, which reviews the process of care received by patients with sepsis. This report sets out to identify, in greater detail, remediable factors which, if addressed, would improve the quality of care of patients with sepsis.

Sepsis is defined as an overwhelming response to infection in which the immune system initiates a potentially damaging systemic inflammatory response syndrome (SIRS) which can manifest in a number of physiological changes, recognised by worsening vital signs.