NEWS – the National Early Warning Score: This was launched in 2012, and developed in
response to a number of national enquiries into patient deaths in hospitals. This identified
the need for early detection to improve patient outcomes, and the importance of having some
sort of early warning scoring system. That’s why we developed the NEWS. It’s national
because it’s important to have a single system that is standardised across the NHS,
so that we’re all speaking the same language, we’re all using the same system for education
and training, and we understand what it means when we move between organisations.
The NEWS is simple. It’s based on the six basic physiological parameters that we normally
measure in hospitals. That is: pulse rate, blood pressure, respiratory rate, oxygen levels,
temperature and conscious level. When we become ill, these begin to vary, and
it’s the variation from the norm that we allocate a score to, which is very simple
to record, and the aggregate of that score gives you a very accurate measure of illness
severity. And we use that as a basis for triaging the response to patients.
More recently this year, we’ve updated the NEWS and introduced NEWS2 with three new elements.
The basic system is the same – we’ve simply enhanced it and improved it. We’ve added:
New ‘confusion’ as a scoring parameter because we know when somebody becomes acutely
confused when they’re ill, this is a very powerful sign of clinical deterioration.
And we’ve improved the safety of oxygen prescribing by providing a dedicated chart
for patients with type two respiratory failure and COPD.
And importantly, we’ve recognised that a threshold score of five for NEWS in patients
who might be septic because they have an infection or are at risk of infection, should make us
all think – is this sepsis? If you have somebody at risk of sepsis with a score of
five, think – is this sepsis? We think this will greatly increase the early detection
of sepsis, which is so important in improving the outcome of these patients.
Now, who should be using NEWS? Well basically anybody who is making measurements of these
physiological parameters in the system. And for training, it’s very easy – we’ve
created a really good online training module which you can access from the Royal College
of Physicians website, or simply by googling the National Early Warning Score – you’ll
find it there. And it’s a half hour simple module after which you get accreditation in
the NEWS. NEWS has now been endorsed by NHS England,
the National Quality Board and NHS Improvement as THE early warning scoring system for use
across the system. In addition, NEWS is mandated for use in acute
hospitals, and by acute ambulance trusts. We’d like to see it used across the entire
system, because we’re already seeing early examples of where NEWS is used extensively
– reductions in hospital mortality which are very significant, and also reductions
in cardiac arrest rates. There seems little doubt that the implementation
of a National Early Warning Score will make our hospitals safer, will detect acute illness
deterioration faster, will respond faster, and improve the likelihood that our patients
will survive form acute illnesses. That is the purpose of NEWS.