Patients lives at risk due to delays in treating sepsis

Experts warn that patient’s lives are being put at risk by medical professionals due to delays in treating sepsis.

A patient should be put on an antibiotic drip within an hour after the life-threatening condition sepsis is first suspected. However, recent research carried out by BBC News has highlighted that around 25% of patients in England wait longer.

For the last three years, hospitals in England have had to report their identifying and treating of sepsis. Less than 1% of hospital trusts’ budgets has been held back in order to give them an incentive to take part and improve their performances. One such measure is how quickly antibiotics are given to patients.

The BBC analysed figures from over 100 hospital trusts across the UK, with approximately 75 of those being NHS England Trusts.

The figures show that around 75% of patients received treatment for sepsis within the hour between January and March this year, meaning that a quarter did not.

Wards and A&E Departments performed fairly similarly; however, A&E department performances have improved since early 2017 when 3/5 of patients were given antibiotics within an hour.

The BBC’s analysis of NHS England figures also highlights the vast differences between trusts, as in a number of hospitals over half of patients faced delays.

Treating sepsis with antibiotics within first hour after the condition is suspected is the standard for the rest of the UK too, and in Wales around 71% of A&E patients and 83% of hospital patients had antibiotics within an hour, as well as checks and tests.

Unfortunately, Scotland and Northern Ireland could not provide any recent figures.

Improving

NHS England hit back to say there were signs that performances across the country are improving, adding that hospitals are getting better at spotting those individuals at risk of sepsis sooner.

Dr Ron Daniels, of the UK Sepsis Trust, said the "concerning" figures showed patients were being put at risk. Dr Daniels said the one-hour window was "essential to increase the chances of surviving".

"There is no reason really why it should take longer," he added.

Should anyone wait longer than an hour?

There is no denying that fast treatment of sepsis is essential for increasing the chances of survival.

However, it can be argued that there are valid reasons for waiting longer than the hour suggested to receive treatment, such as doctors waiting for tests to come back, further assessment may be needed or there could be concern regarding allergies and antibiotics.

NHS England's Celia Ingham Clark said there had also been an emphasis on improving the way suspected cases are identified by introducing clear screening protocols.

"It's important not to automatically give antibiotics to everyone, instead we want to identify the sickest patients and get them assessed and then quickly give them antibiotics."

Helen Dolan, Senior Partner and Head of Clinical Negligence here at Potter Rees Dolan, comments:

It is alarming to read, despite the NHS’s huge and costly campaign to raise public awareness and report symptoms, that around a third of patients in England are not being given antibiotics within the suggested hour after signs of sepsis have been spotted.

A short delay in commencing treatment can mean the difference between life and death and so it is crucial that all patients with suspected sepsis are put on the correct treatment pathway as quickly as possible. Sadly we still see cases where these very basic interventions are not carried out an early stage with tragic consequences.

What is sepsis?

Sepsis can develop as a side-effect of an infection, sometimes due to ineffective treatment of the initial infection. It develops when the chemicals released by the immune system to fight an infection cause inflammation throughout the body. If sepsis is allowed to develop without effective treatment, the patient can go into septic shock and this can lead to long term injuries and sometimes death.

People can develop sepsis after all sorts of infections, including lung, bladder, skin, bone, heart and brain infections. It can also develop after surgery, and we often see cases where a patient has developed sepsis and septic shock as a result of a delay in diagnosing a bowel perforation during or after surgery. In those cases, the patient often develops intestinal failure and require a stoma.

The life-threatening blood poisoning condition is estimated to claim the lives of around 52,000 individuals in the UK a year.

What are the symptoms of sepsis?

In adults:

• slurred speech
• extreme shivering or muscle pain
• passing no urine in a day
• severe breathlessness
• high heart rate and high or low body temperature
• skin mottled or discoloured

In children:

• looks mottled, bluish or pale
• very lethargic or difficult to wake
• abnormally cold to touch
• breathing very fast
• a rash that does not fade when you press it
• a seizure or convulsion

Helen Dolan is a senior partner and head of the clinical negligence department at Potter Rees Dolan. Should you have any queries about clinical negligence issues and wish to speak with Helen or any other member of the team please contact us on 0161 237 5888. Alternatively, you contact Helen directly here.