National Institute for Health and Clinical Excellence (NICE)
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NICE consults on guideline to speed up recognition and treatment of sepsis

NICE – the National Institute for Health and Care Excellence – has published a new draft guideline to help healthcare professionals working in any NHS setting to recognise sepsis so they can provide early treatment.

Sepsis is caused when the body’s immune system becomes overactive in response to an infection, causing inflammation which can affect how well other tissues and organs work. When sepsis is recognised early, people can be quickly given the right treatment. However, the signs and symptoms of sepsis can vary and may be subtle which can lead to it being missed if it is not considered early on. A recent independent, expert report by NCEPOD (the National Confidential Enquiry into Patient Outcome and Death) revealed delays in identifying sepsis in over a third (36%) of cases.

Professor Mark Baker, director of the centre for clinical practice at NICE, said:“There are around 123,000 cases of sepsis in England every year and unfortunately thousands of people die after developing the condition. Many of these deaths might be prevented if sepsis was recognised quickly and treatment started early. We know that when hospitals are well prepared, clinicians do better at responding to patients with sepsis; however recent reports have revealed that a third of hospitals have no formal protocols for recognising and responding to sepsis.”

The draft recommendations, which have been published for public consultation, cover the recognition, diagnosis and early management of sepsis, including:

  • What signs and symptoms to look out for, how to identify those at high risk of developing sepsis and which clinical tests to use to diagnose and monitor.
  • How to care for people with suspected sepsis outside of hospital and when they should be referred for emergency care.
  • Appropriate use of antibiotics and other supportive treatments such as fluids and oxygen.
  • The type of information which should be given to people with sepsis as well their families and carers

Professor Baker added: “We want all healthcare professionals to see sepsis as an immediate life-threatening condition and make sure there are systems in place across the NHS for it to be recognised and treated as an emergency. This new guideline will be the first to provide evidence-based best practice advice on how to quickly identify and treat people with sepsis. We now urge all healthcare professionals and organisations with an interest in this area to comment on the proposed recommendations.”

Celia Ingham Clark, NHS England’s national director for reducing premature deaths, said: “Sepsis can be extremely difficult to recognise and diagnose, but it can be prevented, and it is treatable in many cases. NHS England has recently published a new system wide action plan to ensure that healthcare professionals are supported and equipped to identify and treat sepsis early. The development of this new guideline will be a valuable addition to the ongoing work the NHS is under taking to tackle this serious condition.”

The draft version of this guideline has been published for consultation. Organisations can register as a stakeholder on the NICE website and have until Monday 22 February 2016 to submit their comments. Individuals are ideally advised to pass comments through a registered stakeholder organisation that most closely represents them.

For more information call the NICE press office on 0300 323 0142 or out of hours on 07775 583 813.

Notes to Editors

Further information

  1. The draft guidance is available at /guidance/indevelopment/gid-cgwave0686.
  2. According to the National Confidential Enquiry into Patient Outcome and Death, 2015 'Just Say Sepsis' report which studied a sample of 3,363 patients from 305 hospitals in 2014:
    - There was a delay in identifying sepsis in 36% (182/505) of cases, severe sepsis in 51.5% (167/324) cases and septic shock in 32.6% (63/193) cases.
    - 33.8% (184/544) of hospitals studied had no formal sepsis protocol.
  3. In 2015 NHS England published a cross-system action plan on improving outcomes for patients with sepsis, the full report is available here:https://www.england.nhs.uk/wp-content/uploads/2015/08/Sepsis-Action-Plan-23.12.15-v1.pdf

About NICE

The National Institute for Health and Care Excellence (NICE) is the independent body responsible for driving improvement and excellence in the health and social care system. We develop guidance, standards and information on high-quality health and social care. We also advise on ways to promote healthy living and prevent ill health.

Our aim is to help practitioners deliver the best possible care and give people the most effective treatments, which are based on the most up-to-date evidence and provide value for money, in order to reduce inequalities and variation.

Our products and resources are produced for the NHS, local authorities, care providers, charities, and anyone who has a responsibility for commissioning or providing healthcare, public health or social care services.

To find out more about what we do, visit our website:www.nice.org.uk and follow us on Twitter: @NICEComms.

 

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