Standard operating procedure

Sepsis & Deteriorating Patient Procedure

How [Organisation Name] recognises, assesses, immediately manages and safely escalates patients with suspected sepsis or acute clinical deterioration across all contacts

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  • Editable Microsoft Word (.docx)
  • Mapped to the CQC standards
  • Optional 3-monthly updates

What's inside

This standard operating procedure is fully drafted and structured, ready to brand and complete for your service. It covers:

  • 1. Purpose
  • 2. Scope
  • 3. Recognition and risk stratification
  • 4. Responsibilities
  • 5. Equipment
  • 6. Procedure
  • 7. Safety-netting for lower-risk patients
  • 8. Records
  • 9. Debrief, learning and related documents
  • 10. Review and version control
  • 11. Disclaimer

Legislation & standards it maps to

  • Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 - Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance)
  • National Institute for Health and Care Excellence, Sepsis: recognition, diagnosis and early management - NICE guideline NG51 (2016, updated 2024)
  • National Institute for Health and Care Excellence, Fever in under 5s: assessment and initial management - NICE guideline NG143 (2019, updated 2021)
  • Royal College of Physicians, National Early Warning Score 2 (NEWS2): standardising the assessment of acute-illness severity (updated report, 2017)
  • General Medical Council, Good medical practice (2024)
  • Data Protection Act 2018 and the UK General Data Protection Regulation

Who it applies to

All GP partners, salaried and locum GPs, advanced nurse and pharmacist prescribers, practice nurses, healthcare assistants, paramedics and other clinicians working at [Organisation Name], together with reception, care navigation and administrative staff who handle patient contacts

Glossary

Plain-English explanations of the technical terms and legislation used in this document.

111 urgent advice service
The free national telephone and online service that gives urgent medical advice when a situation is not life-threatening.
ABCDE assessment
A structured way of checking a sick patient in order of priority: Airway, Breathing, Circulation, Disability and Exposure.
Adverse event
Any unexpected or unwanted occurrence linked to a treatment that harms, or could harm, a patient.
Anaphylaxis
A severe, life-threatening allergic reaction needing immediate emergency treatment.
AVPU
A quick scale for level of consciousness: Alert, responds to Voice, responds to Pain, or Unresponsive.
Capillary refill
A bedside check of blood flow, done by pressing the skin and timing how quickly the colour returns.
Care Quality Commission (CQC)
The independent regulator of health and social care services in England.
Chemotherapy
Drug treatment for cancer that can weaken the body's ability to fight infection.
Cyanosis
A bluish colour of the skin, lips or tongue caused by too little oxygen in the blood.
Data Protection Act 2018
The UK law that sets out how personal information, including health records, must be handled and kept secure.
Duty of candour
The legal duty to be open and honest with a person and their family when something goes wrong with their care.
General Medical Council (GMC)
The body that registers doctors in the UK and sets the standards they must follow.
Good medical practice
The General Medical Council's core guidance setting out the standards of care and behaviour expected of doctors.
Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
The regulations setting out the fundamental standards that registered care providers must meet.
Immunocompromise
A weakened immune system that makes a person more likely to catch infections and become seriously ill.
Index of suspicion
How alert a clinician stays to the possibility of a condition so it is not missed.
Intravenous (IV)
Given directly into a vein, such as fluids or medicines delivered through a drip.
Mottling
A blotchy, patchy discolouration of the skin that can be a sign of poor circulation in a seriously ill patient.
National Early Warning Score 2 (NEWS2)
A standard scoring system that combines a patient's vital signs to flag how unwell they are and how urgently they need help.
National Institute for Health and Care Excellence (NICE)
The national body that produces evidence-based guidance on treatments and care.
Near miss
An event that could have caused harm but did not, by chance or because it was caught in time.
Neutropenia
A low level of a type of white blood cell, which leaves a person much more vulnerable to serious infection.
NEWS2 parameter
One of the individual vital-sign measurements, such as pulse or breathing rate, that make up a NEWS2 score.
Non-blanching rash
A rash that does not fade when pressed, which can be a warning sign of serious infection such as meningitis or sepsis.
Non-rebreathe mask
An oxygen mask with a reservoir bag that delivers a high concentration of oxygen to a very unwell patient.
Oxygen saturation (SpO2)
The percentage of oxygen carried in the blood, measured painlessly with a clip on the finger.
Patent airway
An airway that is open and clear, so the patient can breathe freely.
Peripheries
The parts of the body furthest from the heart, such as the hands and feet.
Pulse oximeter
A small device clipped to a finger that measures the oxygen level in the blood and the pulse rate.
Records Management Code of Practice
National guidance setting out how long health and care records should be kept and how they should be managed.
Registered Manager
The person registered with the regulator as responsible for the day-to-day running of a service.
Risk stratification
Sorting patients into levels of risk, such as high, intermediate or low, to decide how urgently they need care.
Royal College of Physicians
The professional body for hospital doctors that publishes clinical standards, including the National Early Warning Score 2.
Safety-netting
Clear advice to a patient or carer on what warning signs to watch for and exactly what to do if things get worse.
SBAR
A standard way of handing over a patient clearly and quickly: Situation, Background, Assessment and Recommendation.
Sepsis
A life-threatening reaction to an infection in which the body's response begins to injure its own tissues and organs.
Significant event analysis
A structured team review of an incident or notable case to understand what happened and learn from it.
Standard Operating Procedure (SOP)
A written set of step-by-step instructions describing how a particular task or process should be carried out consistently.
Systolic blood pressure
The higher of the two blood-pressure numbers, measuring the pressure in the arteries when the heart beats.
Traffic-light system
A NICE tool that sorts a feverish child's symptoms into green (low risk), amber (intermediate) or red (high risk).
Triage
Quickly sorting patients by how urgently they need to be seen, so the sickest are dealt with first.
UK General Data Protection Regulation (UK GDPR)
The UK's main data-protection law governing how personal information is collected and used.

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  3. Complete the placeholders for your service, then have it approved before use.
  4. Add the optional updates subscription and we keep it current as guidance changes.

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