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LEADING DOCTOR WARNS NICE SEPSIS GUIDANCE “UNACHIEVABLE”

A leading doctor has said parts of new national guidelines to improve treatment and care for patients with sepsis were “currently unachievable” and could lead to delays in transfers from emergency departments.

Dr Nick Scriven, president of the Society for Acute Medicine, said the National Institute for Health and Care Excellence’s quality standards for the condition – a life-threatening blood infection – contained advice on consultant reviews not agreed with specialist medical societies.

The guidance suggests people with suspected sepsis who receive treatment in emergency departments are seen by a consultant if their condition fails to respond within an hour of initial treatment.

However, Dr Scriven warned there was no evidence available regarding its effectiveness and currently no way it could be implemented due to the large number of unfilled consultant posts across the NHS.

He said the alternative would be for patients to remain in emergency departments until stable

“Clearly anything that is designed to help the early recognition and treatment of this condition is a step in the right direction,” he said.

“However, in the current climate of unfilled consultant jobs in ‘front door’ specialties – up to 40% of consultant appointments unfilled in 2016 – and financial constraints, this is not a practical solution and is currently unachievable.

“It could lead to delays in transfer from emergency departments or have major implications on an already stretched and strained senior medical workforce..”

Dr Scriven said he had “significant concerns” about why the standard – QS4 – was not contained in the initial standards shared with specialist societies for discussion and comment and was not mentioned in NICE’s publicly-available minutes.

“We have submitted our concerns to NICE to ask how inclusion of this standard occurred, the evidence used to recommend it and how NICE believes it could be implemented safely,”

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