It seemed that healthcare professionals were hungry for good news around sepsis improvement. Some might suggest that we did nothing more than to pre-empt this interest, and to publish our data at the right time- the reality was, in fact, a whole lot more demanding than that. It is true that our publication in the Emergency Medicine Journal in 2010 was among the first single-centre improvement reports focusing on getting the basics right rather than the ‘sexier’ early goal-directed therapy stuff, but this wasn’t fortuitous.
Between 2006 and 2010 I’d been working hard at gaining some recognition in advance of our work. Far too much research- research that is much more costly and high-brow than ours- is elegantly reported and then forgotten, serving only to be cited in future work and doing little to change large-scale practice. The success of Survive Sepsis, the education programme behind the Sepsis Six, hadn’t gone unrecognized, I’d come to lead the Surviving Sepsis Campaign’s UK Steering Group and I’d been working hard touring the UK and Europe on the lecture circuit to set the scene for disseminating improvement.
In the beginning, this was, I admit, a little seductive and glamorous. That wasn’t right, but it was the norm at the time. Conferences and speakers were typically sponsored by industry: business class travel, a chauffeur from the airport, good food and nice hotels. I tried to conform- to ensure I discussed the latest research, stimulated debate, met the right people. This carried on for about 18 months, I guess. I haven’t received a penny from industry to give a talk since 2008.
By 2008, two things had happened. First, increasing criticism of industry sponsorship and the ABPI guidelines for interaction with health professionals had dried up the sponsorship.
Second, and far more importantly, I’d realised I wasn’t much good at being an academic. I’m not clever enough, and to be frank I find it elitist and dull. I was much, much better at challenging paradigm and accepted hierarchy. I was morphing into a sort of subversive change agent.
Doctors are rubbish at crossing professional boundaries. Doctors talk to other doctors, from within their own speciality, who share the same professional interests. Check the ‘Difficult Airway Society’ or the ‘Society for Intravenous Anaesthesia’ if you don’t believe me. I had followed the herd, allowed myself to become arrogant and exclusive, and this had to change.
Over the following two years, I stepped firmly out of my comfort zone. I made it my mission to engage with as many disciplines and professions as possible, and to develop an inclusive network with no hierarchy to help to plan and drive change. I met with and spoke to doctors and nurses from all disciplines, Paramedics, Community Nurses, healthcare managers and Governors. I would work alongside Karen, the widow of Jem who had died from sepsis back in 2005. She would come along to the meetings, often unannounced, and tell the story from a victim’s perspective. Powerful, shocking stuff.
We soon formed the UK Sepsis Group, from which an energetic and influential branch in prehospital sepsis soon sprang. I have found Paramedics to be the professional group most enthusiastic and receptive to change. A breath of fresh air. In April 2010, we made a formal application to the Joint Royal Colleges Ambulance Liaison Committee. A year later, and sepsis was high on the radar of Paramedics across the country. More on this later.
The UK Sepsis Group mainstream had begun to become influential in its own right. The Scottish and Welsh had by now for several years been championing change and working with us to achieve it. Northern Ireland was beginning to come on board. Next step- England. The Patient Safety First Campaign, and the NHS Institute, were beginning to take note of what we were up to. This paved the way for the next 3 years, the start and the fruition of our political campaigning and lobbying…