The presence of various early warning scoring systems in hospitals across the UK is leading to a lack of consistency in detecting if a patient’s condition deteriorates. This report advocates standardising the use of a single National Early Warning Score (NEWS) across the NHS in order to drive the ‘step change’ required in the assessment and response to acute illness.
The NEWS, like many existing EWS systems, is based on a simple scoring system in which a score is allocated to physiological measurements already undertaken when patients present to, or are being monitored in hospital. Six simple physiological parameters form the basis of the scoring system:
- respiratory rate
- oxygen saturations
- systolic blood pressure
- pulse rate
- level of consciousness.
A score is allocated to each as they are measured, the magnitude of the score reflecting how extreme the parameter varies from the norm. The score is then aggregated. The score is uplifted for people requiring oxygen. It is important to emphasise that these parameters are already routinely measured in hospitals and recorded on the clinical chart.
The report, prepared by a working party convened by the Royal College of Physicians’ Acute Medicine Task Force, recommends that the NEWS should be used when patients present acutely to hospital and also in the prehospital assessment ie by primary care and the ambulance services. The NEWS could also be adopted as a surveillance system for all patients in hospitals for tracking their clinical condition, alerting the clinical team to any medical deterioration and triggering a timely clinical response.
The Royal College of Nursing
The National Outreach Forum
NHS Training for Innovation