New NHS Guidelines to Prevent Sepsis Negligence
New guidance on the early assessment, diagnosis and treatment of adults with suspected sepsis are to be implemented within the NHS from the beginning of April 2019. NHS Trusts which fail to meet the guidelines may face penalties.
New guidance
In recognition of the difficulties of diagnosing sepsis and the disparity in implementing the current NICE guidelines, new guidance has been developed for the assessment of adults in both primary and secondary care. The new guidelines have been created in collaboration with a range of organisations including the UK Sepsis Trust and the Royal College of Physicians.
The new guidance recognises the complexity of a situation where an illness is difficult to identify in its early stages and yet is associated with a high mortality rate when diagnosis is delayed.
The guidance, which is mandatory, emphasises the following factors in diagnosis:
- The importance of taking into account risk factors such as age, a weakened immune system, diabetes and the impact of recent surgery
- The importance of clinical assessment and judgement
- The importance of observations of changes in the patient's behaviour by family members
Use of the National Early Warning System (NEWS)
NEWS is a system of assessment for adult hospital patients which should assist medical staff in identifying those patients who are acutely ill and require urgent attention.
NEWS assesses patients according to six differing categories and determines action dependent on the total score. The factors which should be assessed are as follows:
- Respiration rate
- Oxygen saturation
- Blood pressure
- Pulse rate
- Level of consciousness
- Temperature
In the new guidance a NEWS score of 5+ along with the suspicion of sepsis 'should prompt the senior clinical decision-maker, using clinical judgement, to start appropriate treatment, as indicated, within an hour of the risk being recognised.'
Monitoring of patients
The guidance further states that where patients do not respond to treatment within an hour, they should be seen by or discussed with a consultant urgently.
Where a patient has not been diagnosed with sepsis, the patient 'should be closely monitored for signs of later deterioration, with a clear plan for review and action if deterioration should occur.'
Primary Care
The guidance refers to the NICE guidelines which recommend a risk assessment for patients in primary care and a clinical assessment to determine the possibility of severe illness. Subsequent steps should be as follows:
- 'Where a primary care clinician suspects sepsis…then the clinician should arrange urgent referral and transfer of the patient to an acute hospital for further assessment and treatment with minimal delay at the scene.'
- 'Where a primary care clinician has considered and discounted a diagnosis of sepsis, they should provide appropriate safety-netting information to the patient/carer in case of later deterioration.'
Medical negligence
When an avoidable delay in diagnosis of sepsis or a misdiagnosis occurs due to medical failings, the patient may suffer a very poor long-term outcome.
In these circumstances, it may be appropriate to consider making a claim for compensation.
Speak to a solicitor
If you or a loved one are suffering the appalling impact of sepsis due to a delay in your diagnosis or treatment, contact Glynns Solicitors to talk to a specialist medical negligence solicitor about your experience.
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