Sepsis awareness

What is sepsis?

Sepsis is a life-threatening reaction to an infection.

It occurs when a person’s immune system overreacts to an infection, such as a lung, urinary tract, pelvis or tummy infection, and starts to damage body tissues and organs. Sepsis has also been referred to as blood poisoning or septicaemia.

If not treated promptly, sepsis is potentially life threatening and could lead to shock, organ failure or death.

It is not known why some people can develop sepsis in response to common infections.

According to NHS England, sepsis “claims more lives than lung cancer, and is the second biggest killer after cardiovascular disease.”

Prevention, symptoms and treatment

In some cases, sepsis can be prevented through early treatment of infections and good hygiene at home and in healthcare settings.

There are many possible symptoms of sepsis and they may be similar to symptoms of other conditions such as a flu or chest infection. Symptoms can also differ between children and adults.

Sepsis requires urgent hospital treatment and is treated through antibiotics. A 2017 research study found that giving antibiotic treatment within an hour of people presenting to emergency departments with sepsis reduced their risk of dying by a third compared to if they were given treatment at a later time.

Whilst many people make a full recovery from sepsis in a few weeks or months after leaving hospital, some may have longer-term effects that last years.

Academic research has found that long-covid and post-sepsis syndrome have similar symptoms, such as fatigue, muscle pain, poor sleep, short-term memory loss and arrhythmia (when the heart beats in an irregular rhythm).

Various stakeholders, including contributors to a 2019 Senedd Cymru/Welsh Parliament inquiry into sepsis, have highlighted a need for more support and resources for sepsis survivors.

See the NHS website for more information and advice on sepsis symptoms, prevention and treatment.

Antimicrobial resistance

Antimicrobial resistance happens when antimicrobial medicines are no longer effective in killing or slowing the growth of microorganisms causing disease. It is a significant threat to public health.

Antibiotic resistance can develop naturally but may be accelerated due to inappropriate and/or overuse of antibiotics. Antibiotic-resistant bacteria are less likely to respond to treatment, causing serious complications, including sepsis.

The latest UK Health and Security Agency (UKHSA) data release (15 November 2023) highlights an increase compared to previous years in the number of bacterial infections that are resistant to commonly used antibiotics. Klebsiella pneumoniae, a cause of sepsis, is becoming increasingly resistant to a range of first-line treatment antibiotics, particularly third generation-cephalosporins (from 13.5% resistant in 2018 to 17.4% in 2022) and piperacillin with tazobactam (from 15.1% to 19.6%).

In addition, of all recorded sepsis episodes, Asian or Asian British ethnic groups had almost double the proportion of antibiotic resistant infections (34.6%) compared to White ethnic groups (18.7%). Black patients were also significantly more likely than White patients to experience antibiotic resistant infections (25.5%).

Data also shows that fatality rates were higher for antibiotic resistant infections than those susceptible to antibiotic treatment.

Data on the surveillance of bloodstream infections in patients attending English critical care units (May 2016 to March 2024) is due to be published by UKHSA on 17 October 2024. This will include data showing how often bloodstream infections occur in critical care in England, the microbes that cause them, and linked factors.

Sepsis statistics

In the 2023-24 financial year, 119,911 hospital admissions were recorded with a primary diagnosis of sepsis (that is, sepsis was the main reason for the admission). 88% of these admissions were emergency admissions.

A single admission to hospital may involve multiple consultant episodes. The number of finished consultant episodes with a primary diagnosis of sepsis decreased by around 40% between 2017-18 and 2023-24 and the total number of diagnoses decreased by 25%.

Source: NHS Digital, Hospital Admitted Patient Care Activity: Diagnosis

Note: A timeseries is only possible back to 2017-18 due to changes to the ICD-10 coding standard for the recording of diagnoses of sepsis.

However, according to ONS data, the number of deaths in England and Wales where sepsis was the underlying cause has risen from 2,630 in 2018 to 4,276 in 2023, an increase of 63%.

The number of deaths where sepsis was mentioned anywhere on the death certificate has also increased over the last five years from 23,185 in 2018 to 26,203 in 2023 (+13%).

Source: ONS, Deaths involving sepsis, England and Wales: 2001 to 2023, 3 June 2024

Public awareness

Experts, including healthcare professionals and charities, have highlighted the importance of improving public awareness of the signs and symptoms of sepsis so that they can quickly see appropriate help when needed.

Various national and international organisations have launched initiatives in the past decade to improve public awareness of sepsis in the UK and internationally, including the UK Sepsis Trust, the Global Sepsis Alliance and the World Health Organisation.

Guidelines and policy for healthcare professionals in England

In July 2016, the National Institute for Health and Care Excellence (NICE) published guidance which has been updated over the years for the public and healthcare professionals on how to recognise, diagnose and manage sepsis early. In January 2024, NICE updated its guidance to recommend “better targeting of antibiotics for suspected sepsis to ensure the right people receive treatment as soon as possible but the medicines are not overused, which can lead to antibiotic resistance”.

In spring 2018, NHS England launched an e-learning programme called ‘Think Sepsis’ for healthcare professionals in primary care and management staff.

NHS England’s 2019 long term plan mentions improving “patient pathways to ensure timely assessment and treatment that reduces the risk of death and disability” for people arriving in A&E with sepsis. It also says the NHS will “build on existing work on preventing patient deterioration including Sepsis”. As part of this, hospital staff must alert senior doctors if patients with suspected sepsis do not respond to treatment within an hour.

In September 2024, the UK Sepsis trust said it was “urging the government to re-prioritise sepsis, ensuring it is treated with the same urgency and resources as strokes and heart attacks”.

Further reading

• National Institute for Health and Care Excellence - Suspected sepsis: recognition, diagnosis and early management
• Senedd Cymru/Welsh Parliament website - “Sepsis”
• NHS website - Conditions, sepsis
• The UK Sepsis Trust - The Sepsis Manual