Abstract

Following a patient story of a death in the community from Sepsis of a young adult seen in the Out of Hours GP service, we became involved with the Advancing Quality Alliance Sepsis Breakout Project and developed a quality improvement project focused on use of NEWS in the community and developing pathways of care into our local acute Trusts. Over the last year we have instituted a programme of training of clinical staff in use of the RCP National Early Warning Score for risk of deterioration in acute illness, supported by modifications to our clinical system to facilitate collection of data in a clinical environment. We have demonstrated continuous improvement in the proportion of patients with objective signs allowing calculation of NEWS prior to referral to hospital for adult patients with infective illness and especially those with suspected sepsis. We have developed pathways of care in collaboration with a local acute Trust including pre-alerting the hospital Sepsis Team of suspected sepsis cases to facilitate their early diagnosis and treatment. We have worked directly with patients with experience of sepsis both personally and in their families, incorporating patient experience stories which form the driving force for wishing to improve systems. Interim results from this project were presented at the Advancing Quality Alliance Sepsis Breakout Project results day in January 2017 but we have continued the project and continue to demonstrate improvement. We hope that this work will add to the available evidence base for the use of NEWS in a primary care environment.