Diolch, Llywydd, and thank you to Angela Burns for continuing to raise this very serious issue. I want to start by recognising that sepsis can be a difficult illness to diagnose, particularly in elderly people, but also in children. And that is part of the challenge in dealing with this successfully. Sepsis is estimated by the UK Sepsis Trust to cause the deaths of around 44,000 people every year in the UK, and that would equate to about 2,200 people here in Wales. The figures show that, over the last five years, the number of people who have died annually in a hospital setting in Wales as a result of sepsis decreased from 2,112 to 1,687, so a real reduction but still a real number of people who have continued to die within our hospitals.

The number of incidents of sepsis in Welsh hospitals in the same period actually increased from 6,950 to 8,313. So, that does show that there is a greater awareness of the illness with more people being diagnosed, but the percentage of deaths is decreasing. Sadly, not all of those deaths will be avoidable, but we can be confident that a number of them are. That is why, since 2013, the Welsh Government has, together with the NHS, made the reduction of the avoidable harm and mortality caused by sepsis a high priority for NHS Wales. I well remember, on World Sepsis Day, when I was a Deputy Minister at the time, Mark Drakeford decided that he would do an event on World Sepsis Day to try and raise awareness, to raise the profile of the condition within the service.

Now, we do recognise, frankly and honestly, that there is always more that needs to be done to combat what can be a deadly disease, but I do want to recognise some of the progress that we have made to tackle this life-threatening condition. To be fair, Angela Burns has recognised this as well. We should be proud of the fact that we are seen as leading the way in the UK in making sepsis recognition and treatment a top priority. Our fight to combat sepsis continues, and a huge amount of work has been done since 2012, when we were the first country in the world here in Wales to implement the national early warning score system, known as NEWS. That should ensure the early escalation of patients who are seen to be deteriorating. And that simple step should ensure that we're using a common language throughout NHS Wales to communicate about deterioration and sepsis. NEWS and sepsis screening have been introduced in all acute clinical areas, in the Welsh ambulance service trust and in many community and primary settings. We should be proud of the fact that, in Wales, NEWS has been standardised in all of our hospitals since 2013.

The main vehicle for that change here in Wales has been the active participation of health boards and individuals in the 1000 Lives improvement service rapid response to acute illness learning set, commonly known as RRAILS—and I'm glad they have an acronym at least within the service. But it's clear that there's still lots of work for them to do. They're a huge important part in helping to try and drive system-wide improvement, because we have to continue to try and live up to the recognition that we received in 2016, when the progress NHS Wales had made in improving the treatment of sepsis was recognised by an award from the Global Sepsis Alliance in the 'governments and healthcare authorities' category.

But, as with all things, we can't assume that progress is obvious, easy and inevitable. We have to constantly review what we are doing to ensure ongoing improvement. There is always more that we are able to do in keeping learning and improving, and peer review is an ideal and important part of that. The RRAILS programme involves peer review of the management of acutely deteriorating patients, and it's been developed to enable each health board and trust to develop a proper plan to approve the acute deterioration services that they have. It is good to hear that this work is already well under way, with a series of visits to health boards already having taken place, and more planned. Both the reviewers and the staff being part of that peer review recognises that it's been an important and helpful conversation for each of them.

Recently, the public services ombudsman commended the 1000 Lives work around the peer review, and he acknowledged the impact that that work is having on improving services and saving lives. Other issues are under way, including the work on the development of a sepsis registry that Angela Burns referenced. But the results of a trial in the Cwm Taf 'sepsis 6 box' study suggest improvements in patient outcome, associated with the use of that box. That includes reduced mortality and intensive care unit admissions, and a significant reduction in NEWS at 24 hours, which is an important marker of patient recovery. I am seriously looking forward to a further evaluation of the trial results, so that final conclusions can be reached to see if we could and should roll that out across the whole country.

I want to try and address the difficult question of a public awareness campaign. I say it's 'difficult' because I understand completely the case that is made about wanting to raise broader public awareness in the hope and the expectation that that would save more lives. The practical problem and question for me is whether the money and the resource we'd put into a public awareness-raising campaign would deliver the outcomes we want in having improved outcomes for people.