What is the sepsis Modern Service Framework?
Key questions answered about the sepsis Modern Service Framework, what it means for the NHS and how NICE is supporting it.
A new framework for better sepsis care
Sepsis is a serious reaction to an infection that can be fatal if not treated promptly. Sepsis was the cause of 133,484 hospital admissions in England in 2024/25.
NHS England’s recently published Modern Service Framework (MSF) for sepsis sets out how the NHS and partner organisations, including NICE, will improve sepsis care. The sepsis MSF is one of 6 MSFs designed to deliver consistent, high-quality care throughout the NHS.
A core government priority introduced in the 10 Year Health Plan for England, MSFs are practical plans that describe what good care should look like. They identify where improvements are needed and how services can work together to improve patient outcomes.
NICE’s evidence-based guidance supports this work, providing the evidence, and supporting services to deliver care that is effective, joined up and focused on improving outcomes.
Why address sepsis?
Sepsis is a significant cause of death and ill health and presents challenges across prevention, diagnosis, treatment and recovery, putting significant pressure on health and care services.
The average person admitted with sepsis stayed in hospital for 14 days and in 2024/25, sepsis care cost the NHS £1.037 billion.
When people die from an infection, it is most commonly due to sepsis. It develops very quickly and needs urgent treatment in hospital.
Alongside its immediate risks, sepsis can also have long-term physical and emotional effects for patients and carers.
The exact cause of sepsis is not known. It is thought that the immune system overreacts to an infection and starts to damage the body's organs. The risk of getting sepsis may also be affected by the type of infection, age, genetics and any underlying health conditions.
Why is an MSF needed on sepsis now?
In 2024/25, 133,484 hospital admissions recorded were attributed to sepsis, and just over 7% of people with a ‘suspicion of sepsis’ will die during their acute hospital stay. The MSF sets out to address this, with an ambition to reduce death, life-threatening complications and long-term impacts from sepsis and severe infection, in all patient groups, by at least 25% by 2035.
Sepsis can affect anyone, of any age, who has an infection. Diagnosing sepsis can be difficult. It often overlaps with other conditions and severe infections, and no single diagnostic test exists to confirm it. This is particularly challenging when diagnosing sepsis in infants and children.
Compounding this, sepsis care and outcomes vary across the NHS, and inconsistent data makes this variation difficult to understand and address. Clinicians must also navigate the balance between 2 risks. Treating too slowly can be dangerous, but treating too quickly with antibiotics that are not needed contributes to antimicrobial resistance.
Significant health inequalities are prevalent in sepsis care, meaning that some groups are more likely to have poorer outcomes than others. Those at higher risk are:
- babies
- older people
- people from more deprived areas
- those with serious mental illness
- people experiencing homelessness
- some people with a learning disability and autistic people.
What approach does the MSF suggest for tackling sepsis?
The framework sets out what will change in how sepsis risk is understood, managed and responded to across the system, and what support will be available to make that possible.
It is grounded in existing NICE guidance on sepsis, which provides the clinical foundation for the framework. Building on this, the MSF draws on NHS data to develop a much clearer picture of who is at greatest risk of sepsis, and why. This helps services focus care on the people who need it most.
Digital innovation is expected to play an increasingly important role in this work. This includes developing the data and AI-supported analysis needed to spot risk and deterioration earlier and using monitoring devices such as wearables in the home to help identify warning signs in at-risk groups before they escalate.
The MSF is structured around 6 interconnected themes:
- A personalised approach.
- Supporting people to understand sepsis: our staff and the population.
- Prevention of severe infection and sepsis where possible.
- Identification of severe infection and sepsis.
- Escalation of care.
- Response that is timely, appropriate and effective.
In practice, this means raising awareness through staff training and public education, reducing infection risk to prevent infections developing into sepsis, and increasing vaccination coverage to reduce sickness and infection from preventable causes.
High-risk groups will be supported through targeted information and shared decision-making to improve prevention, while earlier identification and faster, more accurate diagnosis will be backed by a national improvement programme to help NHS community and primary care providers better manage deterioration.
Importantly, the MSF is not a static document. It is designed to adapt as it is implemented, evolving as priority tasks are delivered and new ones identified.
One short-term priority is to speed up evaluation and, where the evidence supports it, wider adoption of point of care tests in both community and hospital settings, to support earlier diagnosis of sepsis. Point of care tests are helpful as they can be carried out where a patient is being treated, rather than being sent to a laboratory.
The framework is candid about the scale of the challenge ahead. Delivering on its ambitions will require genuine capacity in the health and care system. The NHS will need to review workforce, equipment and estate requirements.
It also recognises that meaningful progress depends on advances in science, technology, data and analytics. To make this happen, the framework commits to drawing on the expertise of partners across research, academia and industry.
What will it change for services and patients?
The MSF predicts that sepsis care will change fundamentally over the next 10 years, with different approaches to preventing, identifying and treating infection and sepsis.
Care will be more personalised, and services will be designed around people’s needs and experiences. Some treatments, traditionally given in hospital, will be delivered safely and effectively at people’s homes by staff skilled and confident in identifying sepsis.
There will be a strong focus on prevention, with high-quality advice and support helping to reduce the rate of infection, including the use of vaccination.
The way technology is used could significantly change patients' experience of care. Those at higher risk of infection will use monitoring devices, including wearables, at home to flag deterioration to clinical teams, reducing the risk of developing sepsis.
People could use mobile phones and other devices to check symptoms when they feel unwell. This could include measuring heart rate and blood pressure. AI, using data to spot patterns automatically, will then analyse these measurements to identify people who may need medication and direct them to the most appropriate care pathway.
Better testing will be available, detecting when organs are failing or the body’s immune response is overreacting at an earlier stage, enabling faster access to treatment. Those who require intensive treatments will also receive timely access to enhanced care.
The goal is for most people to recover from infection with no long-term impacts, with care delivered consistently across the NHS for all patients.
What is NICE's role?
NICE plays a central role in each MSF, bringing the latest evidence into clinical practice, identifying where guidance is already available and where updates are needed, and making sure every framework is built on the strongest possible foundation.
NICE's sepsis guidance has recently been updated to better support clinicians and improve outcomes for patients.
In November 2025, NICE restructured its sepsis guidance to help health and care professionals find the information that is relevant to the person they are treating, more quickly. Sepsis guidance is now organised into 3 guidelines, covering adults, children, and people who are pregnant or were recently pregnant. The update followed feedback from practitioners about how the guidance was used in practice.
Following a consultation in June 2026, NICE now recommends that clinicians in acute hospital settings consider procalcitonin testing in adults who are not pregnant. This is a blood test that measures the level of procalcitonin protein in the blood and can help identify severe bacterial infections in people with suspected sepsis who are at moderate or high risk of severe illness or death. The guideline previously had no recommendations on procalcitonin use.
A recent update incorporates new early warning systems to help identify pregnant people who are at greatest risk of severe illness or death from sepsis, with further updates underway for children under 16.
The next decade: what success looks like
By 2035, if the framework succeeds, infection and sepsis will be prevented wherever possible, identified early, and treated with speed, precision and compassion. The improvements to identification, escalation and care set out in this framework will mean fewer people reach crisis point, and those who do will be treated faster and more consistently, wherever they live.
Most people will recover fully, with long-term support as standard and far fewer readmissions. Care for people at the end of life will be delivered with the same consistency and compassion as every other stage of the sepsis pathway.
This is the scale of ambition behind the framework's target: a 25% reduction in deaths, life-threatening complications and long-term impacts from sepsis and severe infection by 2035.
NICE's evidence will continue to underpin this work as the framework is implemented, with guidance updated as new research and testing methods emerge. Achieving the framework's ambition will depend on practitioners, commissioners and partners across the health and care system working together, guided by that evidence, to turn it into everyday practice.
Find out more
- Modern Service Framework for sepsis
- NICE guidance on sepsis:
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