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The Sepsis Modern Service Framework

17th Jul 2026

"The Sepsis Modern Service Framework places critical care nursing at the centre of the sepsis journey, from recognising early deterioration and preventing avoidable ICU admissions, to delivering complex critical care and supporting long-term recovery after discharge"

For critical care outreach teams and critical care nurses, several messages in the 260713 Sepsis MSF stand out as particularly important. Rather than focusing solely on sepsis pathways, the framework positions critical care services as central to the prevention of deterioration, the escalation of care, rehabilitation, and system-wide improvement. 

1. Critical Care Outreach is moving from "optional" to strategically important

The framework explicitly recognises that patients with sepsis often require enhanced monitoring before they reach critical care. It notes that critical care outreach teams can support these patients, but that provision is currently variable across England. NHS England intends to examine variation in outreach, enhanced care and critical care capacity, and consider greater standardisation. 

Implication for practice

  • Outreach services are likely to come under greater scrutiny.
  • There may be future expectations around minimum outreach provision.
  • Outreach teams should be prepared to demonstrate impact on deterioration recognition, escalation and timely access to critical care. 

2. Earlier recognition of deterioration is a major priority

A recurring theme throughout the framework is that patients are still deteriorating before sepsis is recognised.

The framework calls for:

  • Better use of NEWS2 and other early warning systems.
  • Recognition of "soft signs" of deterioration.
  • Greater attention to carer and family concerns.
  • Better escalation pathways across all settings.
  • Improved identification of repeated healthcare contacts that may indicate evolving sepsis. 

Implication for practice Critical care nurses are likely to play an increasingly important role in education, surveillance and supporting ward teams to identify deterioration earlier rather than simply responding once deterioration has occurred. 

3. Martha's Rule principles are embedded throughout

The framework repeatedly references the need to:

  • Listen to patient and family concerns.
  • Act on carer worries.
  • Avoid diagnostic overshadowing.
  • Use patient and carer concerns as part of deterioration assessment. 

This aligns closely with Martha's Rule and reinforces the importance of critical care outreach teams being accessible escalation routes for patients, relatives and ward staff. 

4. Enhanced Care (Level 1) will become increasingly important

The framework highlights that:

  • Delayed access to advanced therapies worsens outcomes.
  • Peripherally administered vasopressors are increasingly used outside ICU.
  • More Level 1 enhanced care capacity may be required nationally. 

Implication for practice This strengthens the role of critical care nurses in:

  • Enhanced care settings.
  • Monitoring patients receiving advanced therapies outside ICU.
  • Supporting safe delivery of interventions on wards.
  • Developing escalation criteria and workforce models. 

5. Post-sepsis rehabilitation is now a major focus

One of the strongest messages is that success should not be measured solely by survival.

The framework recognises:

  • Long-term physical, psychological and cognitive consequences of sepsis.
  • High readmission rates following critical care admission.
  • Significant gaps in rehabilitation for critical care survivors.
  • A need for earlier follow up and multidisciplinary rehabilitation. 

Implication for practice Critical care nurses may have opportunities to:

  • Lead or contribute to post ICU follow up services.
  • Develop sepsis survivor pathways.
  • Improve transition from ICU to wards and community services.
  • Support psychological recovery and rehabilitation. 

6. Prevention is everyone's business

Traditionally sepsis work has focused on acute management.

This framework shifts attention towards:

  • Vaccination.
  • Infection prevention.
  • Catheter care.
  • Management of vulnerable groups.

Implication for practice Critical care nurses are well placed to influence:

  • Vascular access standards.
  • Device associated infection prevention.
  • Ventilator associated pneumonia reduction.
  • Education of ward 

7. Data, audit and outcomes will become much more visible

The framework proposes:

  • A new national infection and sepsis audit.
  • Near real-time surveillance.
  • Benchmarking of providers.
  • Measurement of outcomes beyond mortality.

A key measure of sepsis severity will be admission to critical care requiring organ support.

Implication for practice Critical care services should expect increased scrutiny of:

  • Escalation processes.
  • Organ support delivery.
  • Readmissions.
  • Rehabilitation outcomes.
  • Length of stay and mortality data. 

8. Research and innovation create opportunities for critical care nurses

The framework identifies major research priorities, including:

  • Faster diagnosis.
  • Monitoring and deterioration detection.
  • Post-sepsis syndrome.
  • Personalised treatment.
  • Specialist sepsis service.

It also explicitly highlights the need to build research capacity among nurses and allied health professionals. 

The single biggest message for critical care nursing

The framework signals a shift from seeing sepsis as an emergency department problem or a critical care admission trigger, to viewing it as a whole-system pathway. Critical care nurses and outreach teams are expected to contribute across the entire pathway: prevention, early recognition, escalation, enhanced care, critical care delivery, rehabilitation and service improvement. Success will be measured not only by survival, but by how quickly deterioration is recognised, how equitably patients access care, and how well people recover after sepsis. 

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