Improving the blood culture pathway – NHS England

Improving the blood culture pathway – executive summary

NHS England’s report into blood culture practices outlines key improvement steps in the pre-analytical phase of the blood culture pathway. Through targeted recommendations to trust chief executives, clinical and pathology staff, we have an opportunity to improve the blood culture pathway, antimicrobial stewardship and patient outcomes from sepsis.

IBMS President Debra Padgett commented on the report:

"Sepsis is attributed to at least 48,000 deaths a year in the UK. For many patients, if sepsis is caught early, it can be easy to treat and with earlier diagnosis, we could save thousands more lives a year in the UK alone. The IBMS, as a stakeholder of the NHSE AMR Diagnostic Board, welcomes the recommendations listed in the report in support of the development of the blood culture pathway to improve the care of the septic patient.

The two main recommendations; increasing blood volume for analysis and minimising time to incubation are critical in the delivery of consistent patient care and rapid diagnosis of sepsis to allow for guided antimicrobial therapy.

It is heartening to see that the report highlights the IBMS as a partner to evidence best practice and peer-learning. Training and education of all medical staff in the importance of the recommendations by engaging with microbiology colleagues is imperative in delivering better patient care. Time to analysis to enable more rapid diagnosis and ultimately de-escalation from broad spectrum antibiotics is in the best interest of the patient and more widely in the fight to control antimicrobial resistance.

We look forward to liaising with the National Pathology Transformation Team on identifying the most appropriate metrics to baseline and monitor improvement in the pathway and support the pathology workforce in delivery of ongoing accredited services. These new recommendations will undoubtedly significantly increase the workload in microbiology departments, however I would still consider the increase in volume of blood cultured is key to the detection of blood stream infection and care of the septic patient."