So you’ve calculated the NEWS2 score – what happens next?

The RCP has produced a new resource to help clinicians implement treatment following the calculation of a patient’s NEWS2 score.

Since the publication of the second version of the RCP’s National Early Warning Score - NEWS2 – in 2017, clinicians have asked for more clarification on what to do after the score for an individual patient has been calculated. Identifying the severity of illness and when patients are at risk of deterioration has always been important but the COVID pandemic has brought an even sharper focus on the score and follow-up actions. Recent guidance from NHS England incorporates the use of NEWS2 in managing patients with temperature and a cough.

NEWS is a simple scoring system in which a score is given to physiological measurements of patients like their pulse rate, temperature and blood pressure. The measurements are recorded regularly and used to determine if a patient’s condition is deteriorating or improving. High scores mean the patient’s treatment needs to be escalated. While the second version NEWS2 score itself has been in use in nearly all hospitals since 2018, it is clear from some of the questions that not every hospital has the same systems and protocols in place to escalate care.

To support similar management across the NHS, the chair of the NEWS2 guideline development group Professor Bryan Williams and the RCP’s clinical director for quality improvement and patient safety Dr John Dean, have developed with colleagues a new resource to help clinicians implement treatment. This is in addition to the guidance already present in the main NEWS2 document. Advice is given in five categories – new confusion, escalation/response guidance, oxygen scales, receiving acute patients into hospital, and what to do when the NEWS2 scores are incomplete. 

Professor Bryan Williams, chair of the NEWS2 guideline development group said:

‘NEWS2 is now widely implemented and embedded as a common language across the NHS, enabling staff to more effectively detect, communicate and respond to acute illness. As experience of use has grown, a number of common themes have emerged where we felt additional clarification would be helpful. This new information is designed to augment existing guidance and aid appropriate use of NEWS2 in clinical decision making.’

Dr John Dean, RCP clinical director for quality improvement and patient safety said:

‘Reliably identifying the severity of a patient's illness, and the likelihood of their condition deteriorating, is probably the most important assessment we can make in clinical care. The widespread implementation of NEWS2 in the UK and internationally has contributed to reducing hospital mortality. Having a consistent approach as part of our clinical assessment will lead to the biggest impact.’

Notes to editors

The new resource is available to download free from the RCP website.

For further information or to arrange an interview please contact RCP head of strategic communications Linda Cuthbertson on 07748 777919, linda.cuthbertson@rcplondon.ac.uk.

The NHS England Clinical guide to managing the patient with a cough and a temperature during the coronavirus pandemic is here.

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