Advising with empathy and experience

Sepsis death tragedy.

A one-year-old boy who died after NHS staff failed to identify he had septicaemia was "let down", health secretary, Jeremy Hunt, has admitted.

Mr Hunt was speaking at a memorial service for William Mead, from Penryn, Cornwall; who died in 2014, after an NHS 111 call did not lead to him being admitted to hospital.

Speaking at in Truro, Mr Hunt said: "I as health secretary, the government, and the NHS let down William."

He also accepted he had let down William's parents Paul and Melissa, who had organised the service at Truro Cathedral to thank the local community for their support after their son's death.

Addressing the congregation, Mr Hunt said: "I've come here to say sorry. This weekend William should have been enjoying beautiful Cornish sunshine with his parents. We didn't spot his sepsis before it was too late."

An inquest heard William's death could have been avoided if he had been admitted to hospital.

His death also raised fresh concerns that the condition was not being spotted, or treated, early enough.

Sepsis happens when the body's immune system - the way  it responds to bugs and germs - goes into overdrive.

The initial problem can be quite mild and start anywhere - from a cut on the finger to a chest or urine infection, for example - but when the immune system overreacts this can lead to an unintended but catastrophic attack on the body.

If left untreated this sets off a series of reactions, from shock to organ failure and even death.

Major research is continuing to attempt to find out what exactly triggers this sometimes fatal reaction. An NHS England report suggests in 2014, more than 123,000 people suffered from sepsis and around 37,000 people die from it in England each year.

Meanwhile, the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) published in November 2015, says sepsis kills more people than breast, bowel and prostate cancer combined in the UK. It suggests there are as many as 200,000 cases of sepsis a year in the UK, and up to 60,000 deaths.

NCEPOD report author, Dr Alex Goodwin, says the numbers recorded by the NHS are likely to be an underestimate because of the way data is coded.

In separate comments on the death of William Mead, Jeremy Hunt said around 12,000 sepsis deaths a year may be avoidable.

Experts say the crux of the problem in identifying sepsis is that it can present in different ways. In some cases, it can be very obvious that a patient has low blood pressure and a high temperature and patients might breathe rapidly and have a racing pulse.

But early on, all these symptoms can be mistaken for influenza, or other infections, and, an added complication, is advice to GPs not to prescribe antibiotics inappropriately, particularly for viral flu infections.

But without early treatment, sepsis can be fatal and every hour can count. In some cases, there can be very few obvious symptoms, until it is too late.

As the condition develops, symptoms may worsen and some more distinctive warning signs can appear. These vary but, after discussions with sepsis survivors, the UK Sepsis Trust, has compiled a list of the six most common signs.

They include slurred speech or confusion, extreme shivering or muscle pain, not passing any urine in a day, severe breathlessness and mottled or discoloured skin.

A patient's blood pressure may plummet and these are signs that the body's organs, such as the lungs, brain and kidneys, are not getting enough blood and are starting to fail.

In the case of babies and young children, some of these symptoms can present differently.

But experts warn that it is important not to wait until these signs appear and, if they do, help must be sought immediately.

If spotted early, relatively simple treatment can be life-saving. Patients may be given antibiotics and fluids through a drip. Oxygen may also help but, once organs start to fail, patients may need extra support in intensive care.

Experts say simple improvements could be made across the NHS to help prevent sepsis deaths.

The NCEPOD enquiry says there has been poor recording of patients' vital signs - their blood pressure and pulse for example - in both primary and hospital care. Spotting a deterioration in these signs can help stop sepsis in its tracks.

The report recommends more doctors and nurses use early warning systems and screening checklists to prompt them to check for signs of sepsis.

NHS England has published a wide-ranging sepsis action which says that staff need to be trained to spot sepsis and be equipped to treat it correctly.

The catalogue of failings highlighted by the case of William Mead demonstrate that this needs to apply to all frontline staff, from hospitals to helplines. A campaign has been set up in hospitals to help clinicians spot the signs quickly.

Jeremy Hunt has said a tool is now being developed to help better diagnosis of sepsis in primary care too. The health secretary also said that the algorithms on helpline NHS 111 must be checked to make sure they are capable of flagging up sepsis.

 

 

The contents of this article are intended for general information purposes only and shall not be deemed to be, or constitute legal advice. We cannot accept responsibility for any loss as a result of acts or omissions taken in respect of this article.