MICROBIOLOGY
creates significant difficulties in identifying critical patients. Sepsis identification relies on regular observation measurements (for NEWS2 scores), and each set of observations takes 215 seconds per patient. At 100% capacity (for example, in a department with 45 beds), 2.7 nurses are required for hourly observations. At 200% capacity (a daily occurrence), it requires 5.4 nurses. With record overcrowding of 155 patients, it would require 9.1 nurses (half the nursing staff) just for observations.
Dr James concluded that current sepsis identification systems were designed for normal capacity. Ultimately, system- wide flow improvements are necessary to enable effective identification and treatment of conditions like sepsis.
Politics and patient perspective Lord Craig Mackinlay, a Member of the House of Lords, a former MP for South Thanet and a sepsis survivor, provided an important patient and political perspective – highlighting the need to improve early recognition of sepsis both within the NHS and among the general public, as well as increasing investment in suitable, advanced prosthetics for survivors. Before his elevation to the Upper House in October 2024, Lord Mackinlay of Richborough was the Member of Parliament for South Thanet between May 2015 and May 2024. He stood down as an MP at the last General Election after developing sepsis in September 2023, which led to the amputation of his hands and feet. Lord Mackinlay subsequently started the All-Party Parliamentary Group (APPG) for sepsis, and the group has now grown to become one of Parliament’s largest APPGs – with approximately 130 members across both houses. Members help spread awareness about sepsis in their local communities. Lord Mackinlay described how sharing experiences and raising awareness can help to save lives: “It wasn’t long ago that I was walking through the corridors of power, in the House of Lords, and a staff member came up to me and said, ‘You saved my mother’s life’, and I said, ‘how so?’ She said, ‘I listened to a podcast you did about your sepsis experience
Lord Mackinlay described how sharing experiences and raising awareness can help to save lives.
and, on the back of that, my mother was unwell; I took her to hospital and asked the question, could this be sepsis? It was sepsis, and her life was saved.’ “That was more of an achievement than anything I have achieved in over nine and a half years of being a Conservative MP. So, perhaps I have found a new calling,” he commented. Lord Mackinlay pointed out that, despite the high numbers of people affected by sepsis each year, investment and awareness around sepsis lags behind other conditions – such as stroke, which has seen a high-profile ‘FAST’ awareness campaign, which “everybody knows and understands”.
He described sepsis as “the poor
relation”. While the UK Sepsis Trust has been effective in getting posters up in corridors in hospitals and on many ambulances, around the country, he believes that sepsis awareness isn’t “quite as embedded”.
“It is [embedded] within medical locations, but we need it to be embedded within people’s families, so that people recognise it at an early stage – so they don’t end up like me. I’m the ‘halfway house’ of sepsis. If you get it right, you come out of the other side and you may have an extended hospital stay, or lose a digit or two.
If we can get a proper diagnostic test at the right time... not only is that good for the person, it’s a good saving for the country and the NHS Lord Craig Mackinlay
WWW.PATHOLOGYINPRACTICE.COM DECEMBER 2025
“But if you get it completely wrong, you go to a graveyard – 48,000 people die every year. If you get it half right, you end up like me, with significant life changing adjustments. I lost bits of my palate, lost a bit of ear, my nose is damaged, and I’ve lost all four limbs, thankfully below the elbow and knee. “We’re not looking for a silver bullet for some advanced, rare cancer, here. We are just looking to recognise sepsis early… If you administer fluids and antibiotics at the right time, you have every chance of survival. It’s not just possible in an advanced economy like the UK – there is potential for even growing economies around the world, who don’t have advanced medical systems. “There is scope to save literally millions of people, and yet we still hear too many stories, and hear them nearly every week,” he commented.
Pyramid of risk He acknowledged the pressures that clinicians are facing in emergency departments, which means the go- to position is to ‘keep people out of hospital’: “I completely understand; there is a pyramid of risk,” he commented. However, he also pointed out that we hear too many stories of worried parents arriving at A&E with a child, showing symptoms, who are then “turned away on day one”.
“On day three, the parents are back, and they are turned away again – perhaps with advice to give Calpol… and, on day five, they’re back for the last time and they die. The health trusts say ‘we’ve learned lessons’, but how often do we hear that? It is all too familiar. There are a range of tests, but I understand it’s not easy to spot – a lot of it is about hunch and guesswork,” he continued, highlighting the importance of public awareness and listening to the patient and their families. “If I’d considered it a bit further, at the time, I had never felt so ill – inexplicably ill, when I led a fairly healthy lifestyle… The day before, I had a very normal day; I’d done the Jeremy Vine Radio 2 show. I went to my office in the afternoon, and I wasn’t feeling particularly unwell, but I wasn’t feeling quite right. During the night, I was sick multiple times. I had some shivers, but still thought nothing too much of it. It could be something I’d eaten, or a variety of innocuous things. “But by the morning, my wife was saying, ‘you’ve never looked so ill, you look white and I can’t feel your pulse’, so she phoned 999. The paramedics came. My wife had taken many of my vital signs already. My blood oxygen was fine, my heart rate was fine, my blood pressure
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