Learning Lessons from Preventable Sepsis Deaths: The UK Sepsis Trust

Sepsis is a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs.

Sepsis causes the immune system to set off a series of reactions that induce widespread inflammation. This can cause a decrease in blood pressure which reduces the supply of blood to vital organs, starving them of oxygen. Consequently, sepsis can lead to multiple organ failure and death especially if not recognised early and treated quickly.

According to the UK Sepsis Trust [1], it is unclear who is most at risk of developing sepsis. It is estimated that around 245,000 people develop sepsis in the UK each year however, the common denominator is unclear.

The Trust looked at Hospital Episode Statistics for England for 2017 to better understand where sepsis cases develop from:

A study published by the Institute for Health Metrics and Evaluation [2] in January 2020 states that poor countries and children are hit hardest by sepsis deaths. The study also confirms that sepsis is likely the cause of 11 million deaths worldwide a year – that’s a life lost every three seconds.

Additionally, around 40% of survivors of sepsis suffer at least one of a range of physical, cognitive, and psychological side effects. 43% of survivors were still not back at work a year later.

The UK Sepsis Trust

The UK Sepsis Trust was founded in 2012 by NHS consultant Dr Ron Daniels BEM. Renowned for his systems and translation expertise, Ron has spent the past 7 years developing and disseminating the Sepsis 6 pathway across the NHS and globally.

The Trust work to raise awareness of sepsis among the public and health care professionals. Their mission is to:

End preventable deaths from sepsis

Encourage early diagnosis

Lobby politicians to improve standards of care

Provide better support for sepsis survivors

Further develop our understanding of sepsis

Robustly examine the effectiveness of systems change and clinical practice

The Impact of the UK Sepsis Trust

Since 2012, the UK Sepsis Trust has worked hard to put sepsis on the national and global agenda:

Survival rates from sepsis in the UK increased from 70% in 2012 to 80% in 2019 and every year they support thousands of people in their recovery and bereavement

In 2016, The National Institute for Health & Care Excellence (NICE) joined forces with the UK Sepsis Trust to release new guidelines to improve sepsis care across the NHS

In 2017, the World Health Organisation adopted a resolution on sepsis to improve care globally and help reduce the annual death toll of six million people worldwide

Since 2015, the trust has collaborated with several organisations to produce operational clinical tools for all ages across a wide range of healthcare settings. The assessment tool should be used to direct healthcare professionals towards a positive or negative diagnosis. The different assessment charts can be accessed on the UK Sepsis Trust website.

Covid-19 and Sepsis

Dr Daniels explained that despite the devastating impact of Covid-19, the pandemic has provided opportunities for public engagement with the problem of sepsis.

Jean-Louis Vincent from the Department of Intensive Care at the Erasme Hospital in Brussels, Belgium can be quoted [3]:

“Is using the word sepsis for Covid-19 patients just a question of semantics? No, the implications of calling this sepsis are important. First, this dysregulated host response explains why antiviral therapies, including remdesivir, have not been found to be very effective in Covid-19 patients who have become critically ill. On the other hand, immunomodulation with corticosteroids and tocilizumab are valid therapeutic approaches in some patients”

Dr Daniels emphasises that the relationship between Covid-19 and sepsis should be seen as a lesson, it must shine a light on infection management and prevention, improving future practice in the process.

The Fight Against Sepsis

In 2020 The World Health Organization called for global action on sepsis. [4] They found that the effort to tackle millions of deaths and disabilities due to sepsis is hampered by serious gaps in knowledge, particularly in low-and-middle-income countries.

They reported that there is an urgent need for better data. Most published studies on sepsis have been conducted in hospitals and intensive care units in high-income countries, providing little evidence from the rest of the world.

Dr Daniels explains that academic articles are very good at describing what needs to be done in sepsis, however, they fail at turning ideas into action, while charities can fill this gap and turn theory into practice.

Additionally, public space messaging is another great place to push sepsis awareness. The UK Sepsis Trust has put billboards on the side of ambulances and bus shelters to effectively promote the importance of the early detection of sepsis.

The Trust work hard to place safety alerts into the public realm, even working with the producers of Coronation Street to create a storyline around sepsis that was clinically accurate and would demonstrate the severity of the condition.

Awareness is key to reducing preventable deaths from sepsis. The UK Sepsis Trust is pioneering the mission and through their passionate work with the public and the healthcare sector, sepsis will be recognised more frequently.

[1] The UK Sepsis Trust

[2] Institute for Health Metrics and Evaluation. 2020. Sepsis associated with 1 in 5 deaths globally, double previous estimate

[3] Louis-Vincent Jean. 2021. Covid-19: it’s all about sepsis [4] The World Health Organisation

It is estimated that around 245,000 people develop sepsis in the UK each year. In this article, Dr Ron Daniels from the UK Sepsis Trust provides lessons and updates on the ongoing fight to end preventable sepsis deaths.