NHS trusts are being asked to use the Royal College of Physicians' (RCP's) updated National Early Warning Score (NEWS2) to help frontline staff identify deteriorating patients sooner, including those with suspected sepsis.
This advice from NHS Improvement and NHS England follows a patient safety alert issued to all acute and ambulance trusts after the National Reporting and Learning System (NRLS) – the world’s largest and most comprehensive patient safety system – received 100 reports in 2017 of patients whose deterioration may not have been recognised or acted on and who subsequently died. Although these patients may not have survived even with prompt action, the care provided did not give them the best possible chance of survival.
Professor Bryan Williams, chair of the RCP's NEWS development group, said:
This patient safety alert is a welcome development aimed at saving lives by focusing attention on the need to use NEWS2 to better identify patients at risk of sepsis and other life-threatening conditions. I am delighted that a new network of NEWS2 champions is being established to share good practice and facilitate the implementation of NEWS2 in all hospitals in England. This is a big step towards improving patient safety and outcomes in our hospitals.
NEWS2 is based on a simple system in which a score is allocated to six physiological measurements already taken in hospitals:
- respiratory rate
- oxygen saturations
- systolic blood pressure
- pulse rate
- level of consciousness.
The National Early Warning Score was first produced by the RCP in 2012 and updated in December 2017. The updated score emphasises its potential use in identifying serious sepsis in patients with known or suspected infection, or at high risk of infection, and recognises the importance of new confusion (or delirium) as a sign of potentially important clinical deterioration.
The adoption of NEWS2 is vital to standardise how adult patients who are acutely deteriorating are identified and responded to. NHS England’s aim is for all acute hospital trusts and ambulance trusts to fully adopt NEWS2 for adult patients by March 2019.