Hundreds of lives saved through new tech to spot sepsis

The NHS has saved hundreds of people from sepsis thanks to better use of digital technology in hospitals.

In a major nationwide push to tackle the condition, including a one hour identification and treatment ambition, new ‘alert and action’ technology is being introduced which uses algorithms to read patients’ vital signs and alert medics to worsening conditions that are a warning sign of sepsis.

Sepsis – also known as blood poisoning – is a life-threatening response to an infection in the body, where the immune system damages tissues and organs.

Three leading hospitals are using alerts to help identify sepsis and tell doctors when patients with the serious condition are getting worse, ahead of the measures being rolled out across England as part of the NHS Long Term Plan.

NHS leaders in Cambridge, Liverpool and Berkshire are now helping the rest of the health service to adopt tools to spot it, which costs 37,000 lives a year and is notoriously difficult to identify.

In Liverpool, the hospital’s digital system brings together lab results and patient observations into one place to help staff diagnose and treat suspected sepsis, saving up to 200 lives a year.

In Cambridge, deaths from sepsis have fallen consistently over the last three years, with at least 64 lives saved in the past year thanks to the innovative alert and action feature.

In Berkshire since introducing a digital system, the Trust has increased screening rates by 70% with nine in 10 patients now consistently screened for sepsis during admission as opposed to two in ten beforehand, allowing doctors to spot more cases sooner.

The schemes are part of a national effort to push best practice and new technology across the NHS, to help hospitals learn from the success of others and spread use of the best technology further, faster.

This year the NHS also made it mandatory for all hospitals in England to implement national sepsis guidance, including that hospital staff must alert senior doctors if patients with suspected sepsis do not respond to treatment within an hour.

Celia Ingham Clark, medical director for clinical effectiveness at NHS England and NHS Improvement, said: “Sepsis is an extremely serious condition, but as part of the NHS Long Term Plan we have made huge improvements in spotting and treating it quickly, with more than nine in 10 people getting the checks they need.

“Now, with the help of innovative digital tools, the NHS is saving more lives by getting even better at identifying and treating sepsis.

“The systems at Liverpool, Cambridge and Berkshire are life-saving and as more hospitals adopt digital tools, thousands more families will be spared the harm and heartbreak of sepsis.”

Screening rates for sepsis in emergency departments have risen from 78% in 2015 to 91% in 2018.

‘Digital blueprints’, outlining the best in technology within the NHS, have been created by hospitals on NHSX’s Global Digital Exemplar programme, which has allocated funding to 51 acute, mental health and ambulance trusts to help them adopt digital systems.

Dr Simon Eccles, chief clinical information officer at NHSX, said: “As an emergency medicine consultant, I know first-hand how helpful these technologies can be on a busy shift, to alert you to a deteriorating patient who might have sepsis and offering the best possible chance of saving their life.

“As we continue to deliver the NHS Long Term Plan, many parts of the country are using world class technology to save more lives and this programme is helping to ensure that learning is spread right across the NHS so others can benefit from their success.”

Dr Ron Daniels BEM, CEO of the UK Sepsis Trust, said: “Any kind of technology which assists clinicians in making prompt decisions when the warning signs of sepsis are detected should be embraced; with every hour that passes before the right antibiotics are administered the risk of death increases.

“The UK Sepsis Trust welcome these initiatives, especially at such a time when the national spotlight is on the swift diagnosis and treatment of sepsis.

“These innovations involve technology that uses existing recognition strategies for sepsis. In the coming years, however, we expect that our improved understanding of the condition, combined with the embracing of evermore advancing technology, will ensure that we deliver the very best care to the patients who need it most urgently.”

At Royal Liverpool and Broadgreen University Hospitals NHS Trust:

• screening for sepsis is now at 100% in the emergency department and on its wards;
• antibiotic administration for patients with sepsis within an hour has increased to nine in ten in in the emergency department and is up to three in five on wards
• and deaths from septic shock mortality in the under-45s has dropped from six in ten to less than one in ten.

Dr Paul Fitzsimmons, chief operating officer at The Royal Liverpool and Broadgreen University Hospitals NHS Trust, said: “We have seen a major impact on sepsis care with lives saved. In some cases, it would have been impossible to make a diagnosis of sepsis without the help of our digital system.

“By providing automated sepsis alerts from clinical information from multiple sources we are treating septic patients both faster and more effectively – helping our clinicians prioritise doing the right things first and reducing death rates in severe sepsis.”

At Cambridge University Hospitals NHS Foundation Trust:

• There has been a 70% increase in patients receiving antibiotics within the one-hour national timeframe of arrival in the emergency department
• and a 50% increase in the proportion of adult inpatients receiving treatment within an hour of the alert being triggering in the system.

Dr Afzal Chaudhry, renal consultant and chief clinical information officer at Cambridge University Hospitals NHS Foundation Trust, said: “Our ambition as a digital Trust is to use advanced technology to improve patient safety, provide high quality care and contribute to better outcomes.

“Our electronic sepsis alert and action feature, developed collaboratively by our clinicians and in-house digital team, better supports our doctors and nurses in being more aware of the possibility of sepsis and act quickly with appropriate treatment.

“It is an excellent example of how much of a difference digital technology can make to patient safety, care and outcomes.”

At Royal Berkshire NHS Foundation Trust:

• The first UK trust to implement Red Flag Sepsis screening digitally, utilising vital signs and clinical judgement to identify sepsis
• On average have seen a 70% rise in the completion of sepsis screening tools across the trust as a result
• and have developed a more robust system for identifying clinical deterioration due to sepsis on the wards.

Mary Sherry, chief operating officer and deputy ceo at Royal Berkshire NHS Foundation Trust, said: “At the Royal Berkshire Hospital prior to implementation of the electronic screening process, all sepsis screening was completed on a paper screening tool contained within the medical and nursing admission booklet. Whilst the majority of patients had a screening tool started on admission, there was poor compliance with these being completed.

“A retrospective audit of usage also showed that patients were unlikely to have subsequent screening tools completed if there was clinical deterioration after their admission, meaning the capture rate of patients who developed sepsis in the trust was poor.

“Since implementation our compliance and treatment of potential and actual sepsis has continued to increase.”

Hospitals across the NHS are now learning from over 60 pilots, trials and blueprints based on lessons from where new technology has been used successfully across the country.

*  The GDE blueprints can be found on the FutureNHS platform. To register please email: gdeblueprints@nhsx.nhs.uk