Rethinking sepsis training, a new approach designed with care and support staff in mind. The impact of sepsis Sepsis is a serious health concern, and it impacts millions worldwide. In the UK 5 people die from sepsis every hour! This critical illness is an outcome of an infection that triggers an intense immune reaction in the body. If not rapidly managed, sepsis can result in organ failure and ultimately death. The often subtle and insidious nature of sepsis highlights the necessity of prompt detection and immediate medical intervention. Timely and decisive response is crucial to ensure people receive appropriate care without delay. Why did we start this in the first place? Both of us have spent many years working in healthcare. I am a paramedic and Neil Fossett is an experienced emergency medical technician (EMT). We have seen the devastating effects of sepsis first hand. We noticed a gap in training that was provided to front line ambulance and hospital staff and that which is provided to care and support staff. We are all taught about sepsis, the use of tools to enable us to quantify illness and how to escalate care appropriately. Care staff build fantastic relationships with their service users and thus know them incredibly well. Their instincts are often finely tuned and they’re able to spot when an individual may be unwell or need medical attention. However, we found upon speaking to them that it was difficult to quantify and communicate this to GP’s, Nurses and Paramedics. In short, the anecdotes suggested that they felt that they were not taken seriously enough. The NEWS2 scoring system was implemented in 2012 and has since been in use nationally. All ambulance trusts, and hospital trusts use it as it has been found to significantly increase the likelihood of spotting clinical deterioration early. Early enough to be able to implement treatment with a higher likelihood of survival. We wondered why this additional information and toolkit was never expanded out into the health and social care sector. In these settings, where vulnerable individuals are cared for and supported by staff, who really know them well, and are in a great position to be able to spot the subtle signs of illness and sepsis very early. This sepsis training aims to change this disparity and provide these additional tools to the health and social care sector. It aims to empower care staff by enabling them to quantify and communicate illness severity and give them confidence and help to protect our society’s most vulnerable individuals. The development of the course We spent a lot of time researching the most up to date information on sepsis to see if there was any other training like this currently available. We couldn’t find any training that included the use of the NEWS2 scoring system as well as the teaching of taking vital signs that was aimed at care and support staff. Most sepsis training was found to be in the form of e learning packages and barely skimmed the edges of sepsis and deterioration. We wanted to go deeper than this and provide face to face training for staff that included the use of taking vital signs and using the NEWS2 scoring system. Whilst e learning certainly has its place in the learning and development arena, there are some things that just can’t be portrayed well enough via screen time. And we felt that this was one of those subjects. Throughout our research we also found that there are approximately 1.5 million paid carers in the UK. This is a huge number! Imagine the good this course could do if we could reach every one of them with this course?! We spent a lot of time constructing the course and wanted to have an emphasis on storytelling and providing a safe space for others to be able to share their stories if they felt able to. Sepsis is so prevalent that we have yet not come into contact with anyone who has not had some experience with it, be that personally or via a friend or family member. We don’t do death by PowerPoint at NR Medical Training and instead focus on making our courses relaxed and conversational. We don’t see it as a time for us to preach to others, things we know, and they may not. It’s more about sharing knowledge and giving others the space to be able to do the same. We take our roles as trainers very seriously and want others to be able to feel confident and comfortable to ask questions to clarify things, or to share their own experiences. Once we felt confident that we had solid course content, we decided to start to get the word out about the new course. We decided initially to run the course free of charge to all care and support organisations. This would enable us to have proof of concept and get some feedback. It was slow to get going at first – I think a lot of people felt there was a catch as it was free! Once the word began to get out via our social media channels, website and tireless calling round and email sending, we began to gain some traction. We had overwhelmingly positive feedback and homes were implementing the new tools and skills they had learnt from the course. We keep in contact with these homes and ask for case studies as to how they have found using them. We have now had the absolute pleasure of working in collaboration with The UK Sepsis Trust. Following meetings and discussions, they have now co-authored and fully endorsed this course. This means that we can expand our reach even further and get this course out to as many care and support staff as is possible. We would like in particular to thank Dr Ron Daniels BEM, the CEO of The UK Sepsis Trust, Melissa Mead MBE, the partnerships co-ordinator, and Beth Kirkbride the marketing and communications lead. These guys have been so supportive, and it’s a pleasure working with them to get this off the ground. Now due to the demand, and soon to be nationwide coverage we are unable to continue offering this for free. Instead, to aim to keep this as accessible as possible we are running it on a not-for-profit basis. Why is this course so important? We feel, like many others, that care and support staff can often be taken for granted. They often seem to fall under the radar and become hidden from view. The work and dedication of this group of people is absolutely amazing and should be viewed as such by everyone. It’s not a job just anyone can do. I started my career in health and social care and speak from experience when I say it’s not an easy task. It can be difficult, frustrating, and upsetting at times. However, the rewards are second to none. Supporting a dementia patient to carry out a task and seeing them smile, supporting a young person with learning disabilities to bake cakes and you can see the proud smile on their face afterward, or supporting a person with difficult and enduring mental health problems to be able to accomplish something the never thought they were able to. These are the reasons any of us go into caring and supporting roles. To help and support others. Why these positions are not celebrated more I will never know. However, these individuals are amazing people and should have all the tools available to them to make sure they can do their job as effectively as possible, whilst keeping the individual being cared for at the centre of it all. I’ve lost count the number of times I have heard this phrase – “I’m just a carer”. This upsets me deeply. There is no “just” about it. Why is this so prevalent? Perhaps a topic for its whole own blog! I have many thoughts on this and will go into this at another time. However, what we want to do, is to be able to delete this phrase from everyone altogether! We want to empower care and support staff. Be able to give them the confidence and tools they need to succeed in spotting illness early, and ultimately being able to do the best for the people they care for. We hope this course will achieve this and more. We hope it will drive down complications and deaths as a result of sepsis. We want to make it as accessible as possible to everyone who can benefit from it. Who will benefit from this? Ultimately, the people being cared for who are often the most vulnerable groups in our society will benefit from this the most and that is our first aim. Secondly, those caring for these groups will also benefit. They will be empowered, have more confidence and be able to do their job to the absolute best of their abilities. In addition to this, those receiving the training will also know what to look out for in their own friends and families. Finally, as we are running this course not for profit, a percentage of every course booked will go directly to The UK Sepsis Trust charity. This will enable them to continue the amazing work they do. Where is it now? We first went live with the backing of The UK Sepsis Trust on Wednesday 14th June 2023. We’ve already had more enquiries and would love to see even more. We aim to initially roll this out regionally, and then nationally. We have a bank of trainers, all of whom are healthcare professionals. We are essentially an army of paramedics, EMTs, emergency department nurses, and military medics. In time this group will expand to enable us to cover as far and wide as is possible. With support from The UK Sepsis Trust, we aim to get more coverage and make as many care and support organisations aware of this training as is possible. Where would we like it to be and why? We would like to see this course implemented nationwide. 1.5 million care staff in the UK is a huge number. It will take time, determination, and a lot of hard work for us to reach everyone, but we are determined to do so! Looking forward to the future, we feel this course would make an excellent addition to mandatory training packages for care and support staff, just as BLS and manual handling is. If we could get this into colleges and schools that would also be fantastic. Particularly for those young people who are considering a career in healthcare. Ultimately, we feel this course stands to benefit others, particularly those most vulnerable groups. And that is why we started this in the very beginning. Here’s to grit, determination and the courage to think outside the box and do something different!
