Daily Mail

Sepsis postcode lottery

THOUSANDS of children may be dead or disabled due to poor care, warn nurses

- By Ben Spencer Medical Correspond­ent

THOUSANDS of children may have died or become disabled in the past decade because of a failure to end the postcode lottery in sepsis care, say nurses.

There is no national early warning system for identifyin­g whether children have the potentiall­y fatal condition, which affects up to 27,000 youngsters every year.

Although Scotland introduced a checklist to spot sepsis in children in 2017, no such scheme exists in England, Wales and Northern Ireland – despite the fact that nurses have been calling for one for at least ten years.

Today, the Royal College of Nursing Congress in Liverpool will demand that a national Paediatric Early Warning Sign Score (PEWS) scheme for sepsis is launched ‘as soon as possible’ to prevent further deaths and harm and try to ensure patients receive consistent care across the country.

It comes three years after the Daily Mail launched the End the Sepsis Scandal campaign following the tragic case of William Mead, who died at 12 months old after a catalogue of errors and misdiagnos­es by doctors and NHS helpline staff.

A National Early Warning Score system was launched last year to ensure medical staff spot signs of sepsis in adults.

But the system cannot be applied to children because their normal readings change as they grow – so the normal heart rate of a baby is different from that of a five-yearold or a 14-year- old. Children’s bodies can also ‘ hide’ sepsis, meaning doctors may have to look for different symptoms to identify whether they might have it.

Dame Donna Kinnair, who leads the RCN, said the PEWS system would save lives. Estimates suggest as many as 4,000 under-fives die every year from the condition, which is caused by the body’s overreacti­on to an infection. Fiona Smith, who speaks for the RCN on children and young people’s nursing, said progress on launching a national system for spotting sepsis in children had been ‘too slow’.

She said: ‘Some individual hospitals have their own systems but there is no joined-up national standard. We need to introduce it urgently to enable nurses and doctors to recognise and detect a deteriorat­ing child and to instigate early interventi­on to stop avoidable loss of life or long-term harm.’

She said the ‘fragmented’ NHS system was behind the delays and health chiefs needed to work together. Dame Donna added: ‘What you always want is consistenc­y of approach because that creates a safer system for the child, so no matter what door they walk through of any NHS Trust they get consistent care.’

An early warning system for spotting sepsis in children would see hospital nurses and doctors, paramedics and GPs use a checklist to monitor children’s vital signs such as heart rate, breathing rate, blood pressure and temperatur­e. If they scored too high in some categories or they deteriorat­ed quickly, it would be a warning they could have sepsis and need further tests.

In addition, campaigner­s want all hospital staff – including receptioni­sts, porters and cleaners – plus those in GP practices to be given a compulsory one-hour training session to spot sepsis. It could mean other patients have their illness recognised early enough to be treated and could save 14,000 lives every year, they will tell the RCN congress today.

Celia Ingham Clark, of NHS England, said: ‘The NHS has made huge improvemen­ts in spotting and treating sepsis quickly with screening rates in emergency department­s rising from 78 per cent in 2015 to 91 per cent in 2018.

‘The NHS is working with the Royal College of Paediatric­s and Child Health to develop a national early-warning system for children.’

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