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Trusts urged to adopt a standardised clinical assessment system

NHS England endorses the National Early Warning Score

Jo Carlowe

Tuesday, 19 December 2017

NHS England is today asking every hospital trust to adopt the National Early Warning Score in a bid to save thousands of lives.

The National Early Warning Score (NEWS) has been produced by the Royal College of Physicians and is backed by the Royal College for Emergency Medicine, NHS Improvement, the Association of Ambulance Chairs and Sir Bruce Keogh, National Medical Director for NHS England. It is also being targeted by the US Navy. 

NHS England say the system could save nearly 2,000 lives and 627,000 bed days every year. 

The system aims to create a standardised approach to clinical assessment across the country.

It is estimated that the NEWS is now being used in over 70% of trusts but NHS England is setting the goal of having the system in place across every acute and ambulance setting by 2019.

Having the NEWS adopted as the standard system will mean NHS staff who move between trusts are using a consistent set of measures for diagnosing patients.

Under the system, patients are assessed on a series of key measures:

  • Breathing rate
  • Pulse rate
  • Blood pressure
  • Temperature
  • Level of consciousness
  • Oxygen saturation

The results are plotted on a NEWS chart which then gives a score for each measure and the combined number then shows the level of clinical care needed and the risk of deterioration.

A low score of between 1-4 would lead to an assessment by a registered nurse, a medium score of between 5-6 would prompt an urgent review from an acute clinician, such as a ward-based doctor, and a high score of seven or more would see an emergency assessment by a critical care team and a likely patient transfer to a high dependency unit.

Sir Bruce Keogh said: “Air Traffic Control systems around the world use common standards and language to prevent disasters and the NHS, with the safety of millions of patients every year at stake, should be no different.

“If staff move between hospitals and end up speaking at cross-purposes, warning signs are missed and patient care can be compromised. I want to see every hospital in the country using the NEWS approach by 2019 as we continually strive to make sure the NHS delivers the highest standards of care possible.”

A cross-system working group has been established, and will develop and oversee a plan to achieve the ambition. The group is chaired by Celia Ingham Clark, consultant surgeon and NHS England medical director for clinical effectiveness.

NEWS is an update of a system first produced in 2012. The Royal College of Physicians has also developed NEWS2 — an early warning system to improve the detection of clinical deterioration due to sepsis in adults. 

RCP president Professor Jane Dacre said: “This update will mark the beginning of a new chapter for NEWS, as with the support of NHS England and NHS Improvement, over the next year NEWS will become the default early warning score for NHS trusts and ambulances. Patients will benefit from its implementation, and staff will benefit from not having to learn a new score each time they join a new trust. And I hope that NEWS will continue its global journey, saving lives across the world.”

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