Hampshire Hospitals' critical care team has always provided an outreach service for patients or their loved ones who have concerns about their care. For the past two years, this has been formally embedded through Martha's Rule, an initiative inspired by the tragic death of Martha Mills from sepsis.

 

Although the outreach support is, given its origin, inextricably linked to sepsis and the challenges associated with diagnosis, anyone with concerns about care or condition can contact the service. In fact, the initiative has proven so effective that the Trust's maternity units are among the first in the UK to formally embed Call for Concern into their services, and there are plans to extend it to the emergency departments.

 

While awareness of sepsis has increased, the condition itself is often misunderstood. It is not an infection, but a severe complication that can arise as a result of an infection.

 

Professor Matthew Inada-Kim, one of the UK's leading experts on the condition and a consultant at Hampshire Hospitals, explains: "A significant number of emergency hospital admissions are due to an infection and, of those, around 10 per cent will have sepsis.

"Sepsis is triggered most commonly by bacteria, although sometimes by a virus, and this triggers an abnormal, excessive response in the body that can lead to serious harm."

 

For clinicians, patients and their loved ones, the challenge often lies in identifying the symptoms associated with this life-threatening condition quickly.

 

"Healthcare professionals need all the warning we can get that patients might be seriously unwell to ensure they receive early tests and treatment.

 

"We don't know everything about the patient. The most important thing is getting a good history from the people who know them best to find out whether they are acting differently or behaving unusually.

 

"It's the little things, such as losing interest in  their normal activities, being more drowsy than usual, having no interest in watching television when they would normally enjoy it, or going off their food. Those are priceless nuggets of information that might indicate someone has something seriously wrong with them."

 

While anyone can develop sepsis, those at particular risk include the very young and the very old, as well as individuals who are immunosuppressed, such as organ transplant recipients and cancer patients.

 

Patients who may not be able to express how they are feeling, including babies and some people with additional needs, are also at significant risk. In these circumstances, the knowledge and observations of a carer or loved one become particularly important.

 

Reflecting on Martha's Rule and its impact on embedding Call for Concern, Professor Matthew Inada-Kim says: "The day that someone is scared to speak up and ask either for reassurance or to raise the alarm because they are worried about their loved one, or themselves, is a day we have failed as a healthcare system. We absolutely support the idea that people should feel empowered to ask: could it be sepsis?

 

"I am pleased to see meaningful developments towards ensuring we offer a responsive healthcare system that properly listens to the worries of patients and heeds the concerns of relatives."

 

Matt Inada-Kim

Professor & Consultant Acute Physician

 

Find out more about Martha's Rule and Call 4 Concern at Hampshire Hospitals here.