Gemma Ellis, who is the lead sepsis nurse for the University Hospital of Wales and manages their outreach team would tell you that there are two issues here: post-sepsis syndrome and post-traumatic stress disorder. We probably all have an understanding of PTSD, but post-sepsis syndrome is a condition that affects up to 50 per cent of sepsis survivors. They are left with physical and/or psychological long-term effects, such as insomnia—boy, do I know about that one—difficulty getting to sleep, nightmares, disabling muscle and joint pains, extreme fatigue, poor concentration, decreased cognitive reasoning and functioning and a huge loss of self-esteem and self-belief. These lasting issues can be explained, but there is more to PSS that has yet to be understood, such as the disabling fatigue and chronic pain that many survivors experience and is not fully understood. Sepsis survivors have described it as: 'You never feel safe. Every time some little thing happens to you, "Do I need to go to hospital, or is this nothing?" is what you think.'

Which brings me to the story of a lady who e-mailed me on Easter Saturday, distraught—not my constituent, but she'd somehow found me. She'd lost her child in labour and also contracted sepsis. She was treated and recovered. Nine weeks later, Easter Saturday, she felt very, very unwell, had the same set of symptoms as before and was terrified it was sepsis again. Reading her account is shocking. Not only was she rebuffed by A&E and out-of-hours, but there was no recognition that it might be sepsis again, and above all no recognition for the trauma she'd been through and her mental state. I'm in contact with her still. She didn't have sepsis, but she was very unwell. What a situation when an ill person turns to someone like me for help on an Easter weekend, because she was told to go away and get a grip. This is a very small excerpt from her e-mails: 'Doctors said it was found quickly before it could do any damage, but I can't help but think "What if it's back?" I don't even know what I want from this e-mail, but knowing you've been through this yourself, maybe you could help reassure me. I don't know much about sepsis. Doctors didn't really explain much, and Google has all sorts of stories. Thank you for taking time and reading my e-mail'. 

Cabinet Secretary, this sums up for me the real lack of awareness of what sepsis is in the general population, and the enormous gaps in the knowledge base and understanding of a great many in the medical and caring professions. My sepsis was three years ago. Rachel's was last year, and this lady's experience happened at Easter, 11 weeks ago. What has changed? Yes, there is a greater awareness amongst some, and I do recognise the intent of the Welsh Government, but on the ground, changes and training are slow to happen. There are some dedicated teams leading the charge in most health boards, but neither I or others on the cross-party group are convinced that this effort is able to make the changes we need. These teams are being supported enormously by the UK Sepsis Trust, which is led in Wales by Terence Canning, who also has first hand experience of losing a loved one because of sepsis. 

I appreciate that the Welsh Government are seeking to help sepsis survivors by signposting them to services and putting in place self-management plans, but sepsis survivors need far more dedicated support than that. I mentioned the indomitable Jayne Carpenter earlier. Having survived the trauma of losing multiple limbs, she and her husband then went through all manner of hell trying to get support so that they could carry on living in their family home. Social services simply didn't understand the issue. Adaptations to her home had to be fought for, and Jayne describes a punishing means-tested system. The reality is that their marvellous network of family and friends have paid for almost all of the adaptations that Jane needed to carry on with the new normal that is now her life. 

There are actions that can be taken, and I pay tribute to the UK Sepsis Trust for the work they've put into pushing this agenda forward, but I'm calling for more action by Welsh Government. I know there are costs and staff implications, but a public awareness campaign and much more training of everyone, from domiciliary care workers to consultants, is vital. This picture shows NHS England encouraging ambulances to display the UK Sepsis Trust's 'Just ask: Could it be sepsis?' poster. We could do something similar. The chief dental officer in England has agreed to mandate sepsis warning posters in English dental practices. Can we do the same here? The cross-party group survey of general practice showed a woeful lack of recognition and understanding. Can we run a campaign into general practice? Cabinet Secretary, we also need to have post-sepsis clinics, and an understanding that sepsis is a major illness with significant impacts on people. We need to support survivors and families and the bereaved in a much better way, and involve other public services, such as housing and social care. The NHS works in close collaboration with charities such as Tenovus and Macmillan in delivering support for those with cancer. The NHS could work in just such a manner with organisations such as the UK Sepsis Trust. Will you undertake to look at that?

The UK Sepsis Trust are working on a national sepsis registry in England, with a place at the table for NHS England, NHS Digital and the UK Sepsis Trust, amongst others. And here I know that Dr Paul Morgan is leading on developing a sepsis registry for Wales. Could you update us on progress? Because if we can get reliable data, we can target NHS resources more effectively. Can we look at other models that the UK Sepsis Trust are already engaged with and see if any are suitable for Wales? And, finally, Cabinet Secretary, with one voice, we all ask for a properly funded public information campaign in schools, in mother and toddler groups, in care homes, doctors surgeries, anywhere and everywhere, because we all need to ask, 'Could it be sepsis?'