Sepsis care blamed for child death rate

Delays give UK worse record than other nations

DELAYED treatment for young British children with sepsis and pneumonia is driving one of the worst child mortality rates in Europe, figures suggest.

The UK sits 19th in a league table of 28 EU countries for under-five mortality – down from ninth in 1990.

A British child is twice as likely to die before their fifth birthday than one from Luxembourg or Finland.

Experts believe that is because GPs and NHS call handlers are not specifically trained in child health, unlike doctors in other countries.

It means when a toddler has sepsis or another complex condition the symptoms are often missed. Now a major investigation is to examine why fatal delays occur and also focus on treatable infections which often lead to sepsis. More than 1,000 under-fives die with sepsis in Britain every year.

Equivalent sepsis data is not collected in other countries, but child death rates in Britain from meningococcal disease, a leading cause of sepsis, are five times worse than in Sweden, three times worse than France and twice as bad as Germany.

Pneumonia rates, another cause of sepsis, are also far higher among under-fives in Britain than other western European nations.

In September this year we launched our sepsis awareness campaign, revealing shocking statistics that showed 20,000 Scots annually are struck down by the illness every year – killing an estimated 4,000 and leaving others maimed or with serious long-term complications.

It came just a week after the Scottish Government rejected calls for a nationwide awareness push at Holyrood.

At the time we also highlighted the dangers of the condition by revealing that NHS Grampian had been forced to apologise to the family of a cancer patient who had died from the illness after an operation at Aberdeen Royal Infirmary.

Weeks later, following support from a string of politicians – including sepsis survivor Lord Ashdown – health secretary Shona Robison announced a Uturn on the Government’s decision.

Research led by the University of Northampton and funded by the NHS will examine other incidents of serious infection in children under five – from the moment a parent realises their child is ill, through contact with GPs, to admission to hospital.

The way GPs, NHS 111 call handlers and out-of-hours services deal with parents’ concerns will be investigated.

The researchers will initially assess the cases of 20 children in great detail, interviewing every doctor involved, and will then widen the study to see how common the issues are nationally.

Child mortality has significantly improved in Britain over the last 25 years – but every other Western European country now has better rates.

Office for National Statistics data, for 2015, puts UK underfive mortality at 4.5 per 1,000 births although rates have improved 51 per cent since 1990, when 9.3 children in 1,000 died.

But in Portugal child mortality has improved 76 per cent and in Ireland by 61 per cent.

Professor Sarah Neill of the University of Northampton said: ‘Infection is a major cause of avoidable childhood deaths in the UK, particularly in the under-fives, yet we know little about the factors that influence when children are admitted to hospital.

‘Many of these deaths could be avoided, as infections such as meningitis and pneumonia are potentially treatable if caught early enough.’

‘There are some fundamental problems with our health service – when you take a child to be first seen by a GP they are not likely to see someone with training in child health. They might not be aware of the subtle signs and symptoms of child sepsis, which can often be mistaken for other conditions.’

She was also scathing of the NHS 111 hotline, which is promoted as a first port of call.

Professor Neill said: ‘We know the NHS 111 is a problem – they rely on algorithms rather than professional knowledge.

‘In Sweden everyone who answers the phone are nurses with at least some training in paediatrics.’

‘Many deaths could be avoided’