National Infection and Sepsis Audit – Acute NHS settings

Sepsis is life-threatening organ dysfunction caused by a dysregulated host response to infection. While it is an unusual complication of developing an infection, it can be triggered by any infection. When people die from an infection, it is most commonly due to sepsis. Sepsis is complex and hard to diagnose, with no single test and symptoms that overlap with other conditions (NHS England Modern Service Framework, 2026)

Severe infections may lead to the development of sepsis, particularly in at-risk groups, and are one of the most common reasons for emergency admission to hospital.

Both infection and sepsis are major causes of morbidity and mortality in the UK, and costly to the NHS and wider economy:

In 2025 there were over 23,000 deaths involving sepsis (Office for National Statistics).

Patients and carers who we engaged with as part of specification development told us of long-term impacts that some sepsis survivors experience, from reduced mobility and cognitive difficulties, to loss of limbs or vision impairments.

Each year, the NHS in England spends over £1billion on sepsis care, and over £6.5billion on infection care. Wider economic costs are estimated at £10-15billion annually (York Health Economics Consortium, 2017).

1,300 clinical negligence claims were made regarding sepsis from 2020/21 to 2024/25, costing £65.3m in litigation. Most claims relate to delays and failures in treatment and diagnosis.

Several major healthcare initiatives have been launched to help improve care related to sepsis and severe infection, including:

NHS England’s sepsis Modern Service Framework (MSF), which aims to reduce death, life-threatening complications and long-term impact from sepsis and severe infection by at least 25% by 2035, as well as reducing health inequalities (published July 2026).

NHS England’s National Improvement Programme for ‘Optimising the acute management of sepsis’ (as part of the MSF activities).

The National Patient Safety Plan for NHS Wales 2026-2031, which includes sepsis care.

The UK Anti-Microbial Resistance (AMR) National Action Plan, which pledges to strengthen infection prevention and control (IPC) and antimicrobial stewardship (AMS) in health and social care settings

New NICE guidelines for recognition, diagnosis and early management of suspected sepsis, published in November 2025 (NG253-NG255)

Establishing the NISA-Acute audit is a key ambition of the NHS England sepsis MSF, and the audit will be expected to align closely with all the initiatives listed above.

The audit funders have selected ‘early stages of care’ as the initial priority for this audit because this is a critical point for effective severe infection management and the swift identification and treatment of sepsis. Prompt, effective treatment is vital to improving outcomes, and both Prevention of Future Death (PFD) reports and Health Services Safety Investigations Body (HSSIB) investigations have highlighted opportunities to improve care in this area.