Sepsis is a medical emergency that develops when the body’s response to infection begins to damage its own tissues and organs. Without urgent treatment, it can lead to shock, organ failure and sadly premature death.

According to the UK Sepsis Trust, each year in the UK 245,000 people are affected by sepsis with 48,000 sepsis-related deaths, many of whom could have survived had their condition been recognised and treated sooner.

Routine screening offers a measurable way to intervene earlier, and tools like the National Early Warning Score 2 (NEWS2) help clinical staff identify and act on early signs of deterioration, because sepsis can escalate quickly.

Rachael Heyes, senior associate in JMW’s clinical negligence team, explains NEWS2 and the importance of this screening tool and how hospital staff need to fully understand the protocol to make it effective in helping recognise sepsis and essentially saving lives.

What is NEWS2?

Developed by the Royal College of Physicians, NEWS2 is a standardised scoring system used across acute and ambulance settings to determine sepsis.

It is based on six physiological parameters:

1. respiration rate

2. oxygen saturation

3. systolic blood pressure

4. pulse rate

5. level of consciousness or new confusion

6. temperature.

A score is marked for each parameter. A score of five or more typically triggers clinical escalation and further investigation into the patient to be treated for sepsis. Patients with a score of seven or more should receive antibiotics within one hour; others, within three.

Sepsis screening and protocols

Alongside NEWS2, hospitals use the Sepsis Six: six steps delivered within one hour, including antibiotics, oxygen and fluids. The UK Sepsis Trust’s Red Flag Sepsis criteria further help identify high-risk patients in busy settings.

These tools offer a consistent framework for recognising and responding to sepsis, but only if they are used without delay and appropriately. In my experience, nurses are often relied on to complete NEWS2 scoring and escalate patients that require senior review.

Preventable deaths

I have represented numerous families in cases involving a delay in diagnosis of sepsis and a delay in escalation to senior clinicians. In one particular case, the nursing staff used the NEWS2 scoring system but did so incorrectly, resulting in a delay in a young child being seen by senior clinicians and being provided with lifesaving treatment. Had his condition been escalated, he would have survived.

In another case, a young child with sepsis was sent home from A&E with a diagnosis of a viral infection, despite previous blood tests showing a low neutrophil count, indicating that her body was not making enough white blood cells to fight off infection.

This shows the importance not only of timely screening but also ensuring that clinical staff understand hospital protocols.

Impact of improved sepsis screening

Where screening is done reliably, outcomes improve, as reported in trusts who have introduced an "e-sepsis" system.

NHS England has endorsed NEWS2 nationally, recognising its role in preventing unnecessary deaths. Training and support from the UK Sepsis Trust also continues to improve awareness and clinical practice across the NHS.

To continue to prevent avoidable deaths, sepsis screening must be consistent across all settings:

● NEWS2 must be applied regularly and systematically.

● The Sepsis Six should be completed within one hour in high-risk cases.

● Digital tools like e-Sepsis should be adopted nationwide to prompt timely action.

● Mandatory training and auditing should be in place for all clinical teams.

● Coroner findings must be reviewed and acted on locally, with transparency about performance.

These are a call for consistency in applying tools that already exist and something I hope to see actioned to continue to prevent unnecessary deaths from sepsis.