World Sepsis Day Prof John Boulton, Director Improvement Cymru / National Director of NHS Quality Improvement and Patient Safety

Today is World Sepsis day, as many of you are aware. It is strange to think that since we last marked this day so much has changed within the health and care system. Many of us have been at the fore of dealing with the immediate response to the pandemic. It hasn’t ended, and its impact will have connotations for years to come.

Whilst much of health care has changed, certain things haven’t. Patient safety remains a considerable burden to health care systems across the world, both for patients and staff. Sepsis is perhaps the most significant of these safety concerns. As a condition it results from an abnormal immune response to an infection, and can subsequently result in life-threatening organ dysfunction. Globally it remains one of the biggest causes of mortality, accounting for around 11 million lives. In Wales, this equates to approximately 2,200 people and represents approximately 13% of all hospital deaths. Furthermore, of those that survive 40% will suffer from life changing effects as a consequence of the condition [1,2]. Those figures are in the absence of a pandemic. They may well be even higher over the last 2 years.

There is considerable evidence and guidance around the identification and management of sepsis. And over the last decade multidisciplinary teams across Wales have done much to implement and embed this evidence and guidance.

At some point the pandemic will shift, and COVID19 will be viewed as a seasonal illness just like flu and the common cold. But acute deterioration and sepsis, and many other safety issues, will remain a significant challenge. COVID19 will leave a lasting legacy on our health systems. And it may well be that identification and prompt management of the acutely deteriorating patient is one such legacy.

Teamwork, communication, coordination, psychological safety and culture have been central to delivering the amazing health care response that we have seen over the last 18 months. But these aren’t the evidence based clinical interventions, they are the fundamental enablers to safe patient care, and safe environments for staff. Working on these enablers are essential for driving forward the sepsis agenda. And we need to work collectively to continue to reinforce these enablers.

On 17 September, Improvement Cymru will launch its new strategy: Achieving Quality and Safety Improvement. We are changing the way that we support organisations in driving their local quality and patient safety priorities. In doing so we will be more actively working alongside the service on the underlying enablers for safe and effective care. By focusing on these enablers we can continue to support the creation of conditions that help safety issues such as sepsis to be addressed and managed promptly.

Our new strategy will be launched on 17 September, World Patient Safety Day. Follow our channels for the latest updates.

  1. Szakmany T, Lundin RM, Sharif B, et al. Sepsis prevalence and outcome on the general wards and emergency departments in Wales: Results of a multi-centre, observational, point prevalence study. PLoS One 2016;11.
  2. UK Sepsis Trust. 2019.