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Every NHS trust told to bring in early warning checks in war on sepsis

This article was taken from: http://www.telegraph.co.uk/news/2017/12/19/every-nhs-trust-told-bring-early-warning-checks-war-sepsis/

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Every NHS hospital should adopt an early warning system to prevent almost 2,000 needless deaths a year, including cases of sepsis, officials say.

All trusts have been asked to introduce consistent checks, amid warnings that the safety of millions of patients is at stake.

Sir Bruce Keogh, NHS medical director, said the national scoring system, used to identify those at risk of death or deterioration and ensure urgent intervention, should be used by every hospital by 2019.

Senior doctors said the standardised methods, which score patients based on factors such as heart rate, blood pressure, temperature and breathing, had been found to be particularly effective in detecting sepsis.

The deadly infection, known as the “silent killer,” is the leading cause of avoidable death in the UK.

It occurs when an infection – such as blood poisoning – sparks a violent immune response causing the body to attack its own organs.

If caught early it can be treated with simple antibiotics, but cases are often missed.

Senior doctors said a consistent approach – with scores determing whether a patient needs checks from a nurse, doctor, or an emergency assessment by a critical care team – would ensure warning signs were seen and acted upon.

Sir Bruce said: “Air traffic control systems around the world use common standards and language to prevent disasters and the NHS, with the safety of millions of patients every year at stake, should be no different.

“If staff move between hospitals and end up speaking at cross-purposes, warning signs are missed and patient care can be compromised.”

Health officials have told every hospital and ambulance service to adopt the same rules – called the National Early Warning Score (News) system – by 2019.

Currently seven in 10 trusts do so.

If every organisation used the system then 2,000 lives and 627,000 “bed days” could be saved every year, NHS England has estimated.

The system was developed by the Royal College of Physicians, in Britain, and has since been introduced by the US Navy, as well as in parts of India, Europe and the US.

Its president, professor Jane Dacre, said: “Over the next year News will become the default early warning score for NHS Trusts and ambulances.

“Patients will benefit from its implementation, and staff will benefit from not having to learn a new score each time they join a new trust.”

Why is the NHS under so much pressure?

  • An ageing population. There are one million more people over the age of 65 than five years ago. This has caused a surge in demand for medical care
  • Cuts to budgets for social care. While the NHS budget has been protected, social services for home helps and other care have fallen by 11 per cent in five years. This has caused record levels of “bedblocking”; people with no medical need to be in hospital are stuck there because they can’t be supported at home
  • Staff shortages. While hospital doctor and nurse numbers have risen over the last decade, they have not kept pace with the rise in demand. Meanwhile 2016 saw record numbers of GP practices close, displacing patients on to A&E departments as they seek medical advice
  • Lifestyle factors. Drinking too much alcohol, smoking, a poor diet with not enough fruit and vegetables and not doing enough exercise are all major reasons for becoming unwell and needing to rely on our health services. Growing numbers of overweight children show this problem is currently set to continue
  • Last year the Health Secretary launched a publicity campaign to alert doctors and nurses to the dangers of sepsis. It was followed by new standards, which say any cases of suspected sepsis arriving at hospital must be seen by a doctor within an hour.It followed a long campaign by parents to improve NHS awareness, and speed up treatment for sepsis. Melissa Mead following the death of her son, William, aged just 12 months, when doctors failed to spot the condition. Another child, three-year-old Sam Morrish, from Devon, also died from sepsis in December 2010, after a catalogue of NHS errors.

    Under the scoring system, results are plotted on a cahrt, which decides the level of clinical care needed and the risk of deterioration.

    A low score of between 1-4 would lead to an assessment by a registered nurse, a medium score of between 5-6 would prompt an urgent review from an acute clinician, such as a ward-based doctor. A high score of seven or more would see an emergency assessment by a critical care team and a likely patient transfer to a high dependency unit, officials said.

    The NHS has more than 100,000 vacancies, amid rising shortages of doctors and nurses, new estimates suggest. The analysis by Labour shows vacancy rates of 9 per cent across NHS trusts –  up from 8.4 per cent the previous year, with estimates suggesting a shortage of 42,000 nurses and 11,000 doctors.