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Sepsis: National Register

Volume 795: debated on Wednesday 30 January 2019


Asked by

To ask Her Majesty’s Government what plans they have to create a national register for sepsis and severe infection cases.

My Lords, we are making good progress in recognising sepsis and improving outcomes. The Government’s new five-year national action plan for antimicrobial resistance includes a commitment to develop a real-time patient-level data source for patients’ infection, treatment and resistance history, which will be used to inform their treatment. NHS England is co-ordinating this work across the health system, ensuring that all infections, including severe infections and sepsis, are appropriately managed and outcomes improved.

I thank the Minister for that reply. I do not think the House will need reminding that 250,000 UK citizens are affected by sepsis each year and at least 44,000 of them die as a result—too many of these deaths are preventable. I am sure the House will welcome the Government’s recently published antimicrobial resistance strategy; developing real-time patient data for serious infections, especially sepsis, is a major step forward and should be welcomed. Can the Government assure the House that they will work with partners, particularly the UK Sepsis Trust, and that sufficient resources are allocated to achieving this vital, life-saving project?

My Lords, this is a very important area of work. The UK Sepsis Trust has done incredible work to raise awareness of sepsis and ensure that we continue to focus on improving outcomes for patients. NHS England is co-ordinating work across the health system, including working with the UK Sepsis Trust. Of course, we are ensuring that sufficient resources are made available to tackle this devastating illness. The noble Lord has my reassurance on that.

I declare an interest as someone who luckily recovered from a total-body sepsis and organ failure. Although more attention is now being given to this devastating illness, thanks to the UK Sepsis Trust among others, I understand that in its early stages, it is very difficult to diagnose. What kind of training and awareness-raising is being given to GPs and other primary care staff to enable them to identify it at an early stage?

My Lords, that is a very good question. We are working very closely with clinicians to ensure that they have the tools to diagnose this very serious condition. We do not yet have good data on all the long-term effects of sepsis, but we have developed data analysis tools that look at all people admitted to hospital with infections, or sepsis, to see the impact of actions over a long time. Of course, we are training junior doctors and others to recognise sepsis in the early stages of the illness, as people are admitted to accident and emergency, and we have set up data collection for serious incidences of sepsis.

Do the Government recognise that such a registry must go right across primary and secondary care, given that patients present at all parts of the pathway and 25% of survivors have long-term sequelae from sepsis? In that process, will the Government undertake to look at and learn from the 1000 Lives Improvement project in Wales and the HealthPathways project in Cardiff and the Vale, which have themselves learned from experience in New Zealand?

My Lords, the NHS takes this issue very seriously. NHS England and clinicians are working together very closely to make sure that we have good, clear datasets to enable us to diagnose this illness at a very early stage. Where good work is being done, we are looking at that very carefully.

My Lords, sepsis does not respect age; it is our biggest killer, killing more people than breast, bowel and prostate cancer combined. A national register for sepsis could save thousands of lives and reduce the economic burden by £2.8 billion through improving access to healthcare and basic care for sepsis. To collect the necessary data, however, the public need to be brought alongside. What stage have the Government have reached in their conversation about a register with clinicians, patients and the third sector?

My Lords, there is a clear need for better data collection on sepsis, but a registry uses retrospective data collection. Through the Government’s new national action plan on AMR, we will go beyond this and develop real-time patient data collection through data linkage. We will be working on this very closely.

My Lords, my noble friend is quite right to highlight this issue, and collecting this dataset is incredibly important. One of the ways it can be useful is in developing new diagnostic tools that will diagnose sepsis earlier through the use of technology. Can the Minister reassure the House that the dataset that she says will be collected will be available to the researchers and innovators developing these tools, to make sure we can diagnose sepsis quickly, fight it and deal with some of the deaths that my noble friend has highlighted?

My noble friend is right. Data linkage will make it easier to identify those most at risk of infections and sepsis, and to get them treated much quicker. Once that data is available, we will ensure that clinicians and everybody else in the NHS has that information so that they can deliver treatment as quickly as possible.

My Lords, this is about leadership. When the Department of Health and Social Care decided to bear down on hospital-acquired infections, MRSA and C. difficile, and to collect the data and act on it across the NHS, it happened because it was led from the top of the NHS. Would it not be possible to bring the same determination to bear on sepsis in hospitals? We know that GPs have to record diseases and infections, so the infrastructure to do this is there. It requires the political will to make it happen.

My Lords, I can reassure the noble Baroness that the political will is there, and it is being done. This is what data linkage is all about—getting that data much sooner, with patients assessed much quicker than they have been in the past.