Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps she is taking to help ensure rapid diagnoses of sepsis in adults and children.
Answered by Robert Jenrick
Screening, diagnosis and treatment of deterioration from infection, including from sepsis, is supported in all healthcare settings by use of the National Early Warning Score (NEWS2). In England, the NEWS2 tool has been deployed in 98.4% of acute trusts and 100% ambulance trusts.
Infection diagnostic pathway improvement is central to NHS England’s antimicrobial resistance programme. The Office of the Chief Scientific Officer is examining how to accelerate adoption of innovations in diagnostics and apply point-of-care testing to ensure optimal prescribing of antimicrobials in clinical settings, including for the detection of sepsis in adults and children.
Asked by: Wes Streeting (Labour - Ilford North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if his Department will take steps to improve care and support for people following sepsis and severe infection.
Answered by Will Quince
NHS England is working with NHS @Home to allow patients to recover from severe infection and sepsis at home, including in care homes. This includes ‘virtual wards’ which use remote monitoring, technology platforms and wearable devices such as pulse oximeters and through face-to-face community care where patients receive care from multidisciplinary teams.
Outpatient Parenteral Antibiotic Therapy services are also being established and tested in National Health Service trusts to support the ability to discharge patients home safely whilst receiving antibiotic therapy.
Asked by: Rachael Maskell (Labour (Co-op) - York Central)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what steps her Department is taking to help ensure that screening for sepsis is available in all healthcare settings.
Answered by Will Quince
Screening, diagnosis and treatment of deterioration from infection, including from sepsis, is supported in all healthcare settings by use of the National Early Warning Score (NEWS2), a screening tool which assists clinicians to identify and respond to patients at risk of deteriorating from infection.
Additionally, we are working with NHS England to update NEWS2 following publication of the Academy of Medical Royal Colleges’ ‘Statement on the initial antimicrobial treatment of sepsis’ in May 2022, to ensure that clinicians working in acute settings are provided with a framework for clinical judgement of the management and treatment of deterioration from infection, including sepsis.
Asked by: Wes Streeting (Labour - Ilford North)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, if his Department will take steps to review its death certification policy to allow for sepsis, infection and antimicrobial resistance to be registered as causes of death to support the NHS in measuring and monitoring the impact of those conditions.
Answered by Will Quince
Medical practitioners are expected to state the cause of death to the best of their knowledge and belief, including where death occurs as a result of infection and sepsis or where this was a contributing factor. The Department published a revised commitment in the 2022 Addendum to the ‘UK 5-year action plan for antimicrobial resistance 2019 to 2024’ to “work with the relevant professional bodies to seek to enhance training in death certification so that it records AMR where this can be identified as a cause of death”. The Department is working with NHS England and the devolved administrations to explore options for progressing this commitment before the end of the current action plan in 2024.
Asked by: John Spellar (Labour - Warley)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment he has made of the potential risks posed by treatment resistant fungal infections.
Answered by Caroline Johnson
Misuse and overuse of antimicrobials, such as fungal agents, is a factor in the development of drug-resistant pathogens. NHS England’s national pharmacy and prescribing clinical lead is supported by seven regional antimicrobial stewardship (AMS) leads. These AMS leads collaborate with regional National Health Service stakeholders and partner organisations, including infection prevention and control, patient safety, diagnostics and sepsis teams, the Department, the UK Health Security Agency (UKHSA), Health Education England and the Care Quality Commission, to contribute to multi-professional endeavours to mitigate the threat of antimicrobial resistance (AMR).
NHS England’s AMR diagnostics team advise that high-level research has been undertaken to understand the need for optimal fungal diagnostics and resistance testing. This has highlighted opportunities for improvement in data collection regarding the use of diagnostics, surveillance and consistent access to diagnostics.
The UKHSA reports on antifungal resistance against systemic antifungals utilised in the treatment of candidaemia, in the English Surveillance Programme for Antimicrobial Utilisation and Resistance report. Resistance to the key antifungals, amphotericin B, caspofungin and fluconazole, appears to have been decreasing in all Candida species. Fluconazole resistance decreased from 8.2% of Candida blood isolates tested in 2016 to 3.2% in 2020. Resistance to amphotericin B and caspofungin decreased slightly from 2016 to 2020, by 1.3% to 1.1%, and 3.4% to 3.3% respectively.
Asked by: Oliver Heald (Conservative - North East Hertfordshire)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many NHS hospitals follow the sepsis six care pathway approach; and if he will make a statement.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
The information requested is not held centrally. However, all 29 pathology networks in the National Health Service in England have the capability to undertake the tests required to support the diagnosis of sepsis. Healthcare providers are encouraged to adopt the National Early Warning Score (NEWS2) which supports clinicians to identify and respond to patients at risk of acute deterioration, including those with suspected sepsis. Since 2019, NEWS2 has been implemented in 100% of ambulance trusts and all except one acute trust in England.
Asked by: Kevin Hollinrake (Conservative - Thirsk and Malton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, with reference to the 2016 Review on Antimicrobial Resistance: Lord O’Neill’s independent review of antimicrobial resistance in collaboration with the Wellcome Trust, which recommended that all antibiotic prescribing should be informed by rapid diagnostics, what steps he is taking to ensure that primary care settings are equipped with point of care multiplex testing technology.
Answered by Maggie Throup
As part of the United Kingdom’s national action plan for antimicrobial (AMR) resistance, NHS England and NHS Improvement’s AMR programme is examining the adoption of innovations in diagnostics, improving clinical best practice and applying point-of-care testing for urinary tract infections, respiratory tract infections, surgical site infections and acute deterioration, including sepsis.
This aims to identify any gaps in diagnostic pathways and practices with a focus on improving patient outcomes and antimicrobial stewardship in National Health Service and community care settings. Optimising the potential use of point-of-care multiplex testing in primary care is also being considered. NHS England and NHS Improvement supports the appointment of diagnostics and antimicrobial stewardship leads in each regional team in England. Additionally, national guidelines and national toolkits such as TARGET in primary care and ‘Start SMART then focus’ in secondary care, support antimicrobial stewardship, including the appropriate use of diagnostic tests and tools.
Asked by: Kevin Hollinrake (Conservative - Thirsk and Malton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made on the effectiveness of rapid point of care diagnostics across the NHS in helping the UK to be a world-leader in the delivery of antimicrobial stewardship programmes.
Answered by Maggie Throup
As part of the United Kingdom’s national action plan for antimicrobial (AMR) resistance, NHS England and NHS Improvement’s AMR programme is examining the adoption of innovations in diagnostics, improving clinical best practice and applying point-of-care testing for urinary tract infections, respiratory tract infections, surgical site infections and acute deterioration, including sepsis.
This aims to identify any gaps in diagnostic pathways and practices with a focus on improving patient outcomes and antimicrobial stewardship in National Health Service and community care settings. Optimising the potential use of point-of-care multiplex testing in primary care is also being considered. NHS England and NHS Improvement supports the appointment of diagnostics and antimicrobial stewardship leads in each regional team in England. Additionally, national guidelines and national toolkits such as TARGET in primary care and ‘Start SMART then focus’ in secondary care, support antimicrobial stewardship, including the appropriate use of diagnostic tests and tools.
Asked by: Kevin Hollinrake (Conservative - Thirsk and Malton)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, what assessment his Department has made of the potential merits of increasing adoption of rapid point of care diagnostics to support antimicrobial stewardship objectives within (a) primary and (b) community care settings across the NHS.
Answered by Maggie Throup
As part of the United Kingdom’s national action plan for antimicrobial (AMR) resistance, NHS England and NHS Improvement’s AMR programme is examining the adoption of innovations in diagnostics, improving clinical best practice and applying point-of-care testing for urinary tract infections, respiratory tract infections, surgical site infections and acute deterioration, including sepsis.
This aims to identify any gaps in diagnostic pathways and practices with a focus on improving patient outcomes and antimicrobial stewardship in National Health Service and community care settings. Optimising the potential use of point-of-care multiplex testing in primary care is also being considered. NHS England and NHS Improvement supports the appointment of diagnostics and antimicrobial stewardship leads in each regional team in England. Additionally, national guidelines and national toolkits such as TARGET in primary care and ‘Start SMART then focus’ in secondary care, support antimicrobial stewardship, including the appropriate use of diagnostic tests and tools.
Asked by: Jim Shannon (Democratic Unionist Party - Strangford)
Question to the Department of Health and Social Care:
To ask the Secretary of State for Health and Social Care, how many people in NHS hospitals have contracted sepsis in each of the last three years.
Answered by Maria Caulfield - Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)
Data on the number of people in National Health Service hospitals who have contracted sepsis is not currently held centrally. Reliable estimates of incidence and prevalence of sepsis are not available due to an inconsistency in definitions used to describe sepsis and in coding practice between professionals and organisations. NHS England and NHS Improvement are working to achieve more consistent early identification and treatment of sepsis to improve survival rates and long term outcomes for patients.