Standing up to sepsis
Ron Daniels discusses the challenge of raising awareness about sepsis
Ron Daniels is one of the founders and chief executive of the UK Sepsis Trust. He has spent his career improving the management of sepsis through his role as a consultant in critical care and anaesthesia, and as chief executive of the Global Sepsis Alliance. He has worked at Good Hope Hospital in Sutton Coldfield since graduating from the University of Birmingham in 1994. Daniels and colleagues at Good Hope Hospital developed the “sepsis six” care bundle, which is endorsed by NHS England and the UK royal colleges. In 2016, he was awarded a British Empire Medal (fig 1 ).
Congratulations on being awarded the British Empire Medal. What does it mean to you?
To have our [UK Sepsis Trust] work recognised by the Queen is astonishing. It’s an award for me and for all the people who have been working so hard to bring sepsis to the fore of the NHS’s priorities. It validates the work we’ve done and invigorates the fight moving forward.
What is sepsis and how big a problem is it?
Sepsis is a life threatening condition that happens when the body’s response to an infection injures its tissues and causes multiple organ dysfunction. We estimate that there are 150 000 sepsis cases each year in the UK with 44 000 deaths. That’s more than bowel cancer, breast cancer, and prostate cancer combined.
One of the biggest challenges with sepsis is that it can arise from several infections and it can affect anyone, from babies to older people. We [the UK Sepsis Trust] believe that we can save another 14 000 lives every year by better communicating the sepsis six steps that healthcare professionals should follow once sepsis is suspected.
What inspired you to tackle sepsis?
In 2005, I saw a young patient who had sepsis. Despite maximum treatment, his condition deteriorated. After speaking to his wife, it was clear that there had been a failure to identify sepsis earlier on, and that the healthcare service had let him down. I turned her world upside down by telling her that her usually fit, strong husband wouldn’t be coming home. It was then that I thought, “we need to fix this.”
How did you make the sepsis six campaign such a success?
We [Ron Daniels and colleagues at Good Hope Hospital] started with the existing “surviving sepsis” campaign guidelines and then picked out actions that a junior member of staff could perform (such as the administration of intravenous antibiotics) as the basis for the sepsis six campaign. We then tested the process and showed a reduction in death rate from 44% to 20% when the guidelines were followed. The simplicity of our campaign and the branding behind it encouraged its spread. Now the sepsis six is used in 96% of British hospitals and 13 countries worldwide.
What are the main challenges we still face in the fight against sepsis?
Most cases of sepsis are acquired in the community, so we [the UK Sepsis Trust] have to educate the public about the symptoms so that they access healthcare quickly. We also need to work with colleagues in community based care to ensure that they can identify sepsis early and escalate cases when it is suspected.
How difficult was it to bring about change on a national level?
It has taken more than a decade of hard work by the UK Sepsis Trust team. We have been lobbying for six years and have worked alongside bodies such as the National Institute for Health and Care Excellence and NHS England to get to a stage where we can influence national policy. On an international level, other countries look to us for advice about how to achieve such change. The key to all of this has been the simplicity of our campaign.
If the sepsis six were expanded, what additional elements would you include?
We refine the sepsis six when new evidence comes to light. For example, we initially recommended high flow oxygen therapy, but new evidence has shown that this could cause hyperoxia. Therefore, we now suggest giving oxygen that maintains saturations above 94%. One thing that is not currently included in the six steps is escalation to critical care, but this is explicit in the accompanying educational material, such as the sepsis six pathway forms used in NHS trusts.
How do you make time for your charity work alongside your job as a consultant?
Since 2005, when I was struck by a passion and belief that we needed to do something about death rates from sepsis, finding the time hasn’t been difficult. Some weeks I give 50 hours to the charity and I love every moment of it. I have had brilliant fun on this journey and can’t see that ever changing.Chelsea Bolwell,
Good Hope Hospital, Sutton Coldfield, UK
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.