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The UK Forum for Multi-Professional Critical Care Outreach, 
   Medical Emergency, Acute and Rapid Response Teams

This is the latest version of the National Early Warning Score (NEWS), first produced in 2012 and updated in December 2017.

NEWS2 has now received formal endorsement from NHS England and NHS Improvement to become the early warning system for identifying acutely ill patients - including those with sepsis - in hospitals in England.

How the NEWS works

The NEWS is based on a simple aggregate scoring system in which a score is allocated to physiological measurements, already recorded in routine practice, when patients present to, or are being monitored in hospital. Six simple physiological parameters form the basis of the scoring system:

      1. respiration rate
      2. oxygen saturation
      3. systolic blood pressure
      4. pulse rate
      5. level of consciousness or new confusion*
      6. temperature.

*The patient has new-onset confusion, disorientation and/or agitation, where previously their mental state was normal – this may be subtle. The patient may respond to questions coherently, but there is some confusion, disorientation and/or agitation. This would score 3 or 4 on the GCS (rather than the normal 5 for verbal response), and scores 3 on the NEWS system.

A score is allocated to each parameter as they are measured, with the magnitude of the score reflecting how extremely the parameter varies from the norm. The score is then aggregated. The score is uplifted by 2 points for people requiring supplemental oxygen to maintain their recommended oxygen saturation. This is a pragmatic approach, with a key emphasis on system-wide standardisation and the use of physiological  parameters that are already routinely measured in NHS hospitals and in prehospital care, recorded on a standardised clinical chart – the NEWS2 chart.


National Early Warning Score (NEWS) 2

NHS England and NHS Improvement have endorsed a single early warning score – the National Early Warning Score (NEWS) – for use in acute and ambulance settings.

NEWS is a tool developed by the Royal College of Physicians which improves the detection and response to clinical deterioration in adult patients and is a key element of patient safety and improving patient outcomes.

Since its initial launch in 2012, NEWS has seen widespread uptake across the NHS. At present around 70% of acute trusts in England are using NEWS, with other Early Warning Scores in place in other areas. The confusion caused by the current variation in practice can compromise patient safety, something that would be eliminated by use of a common tool. With this in mind, NHS England, with the support of NHS Improvement are endorsing NEWS, and are launching an ambition to increase its use to 100% of acute and ambulance settings by March 2019.

Through standardisation of NEWS we can reduce the number of patients whose conditions deteriorate whilst in hospital, and potentially save over 1800 lives a year.

NHS England have set up a Cross-System Working Group that will work to increase the uptake of NEWS and ensure its standardised implementation. With representation from: NICE, CQC, AHSNs, clinicians and academics the group will seek to:

  • Implement the national ambition to increase the uptake of NEWS
  • Develop and oversee a work programme to ensure all NEWS-related activity is consistent with the national ambition and identify any barriers to standardised uptake.
NEWS e-learning
Find below the link for the NEWS e-learning v3. An uodated version for NEWS 2 will be released in 2018
For an update about NEWS e-learning click here

 Some of the concerns about the National Early Warning Score has been around the fact that there is no score for urine output. We have contacted the National Acute Kidney Injury group regarding the position about the National Early Warning Score and their stament is as follows:

"The Acute Kidney Injury group would like to endorse the National Early Warning Score but would like to state that urine output is a sensitive issue, it is important that there is accurate recording of fluid balance but there should be avoidance of unnecessary urinary catheterisation"

The National Early Warning Score

Thank you to the organisations that have already completed the survey about the implementation of the National Early Warning Score 2012-2013.

NOrF - NEWS implementation survey completed

  • Addenbrookes Hospital
  • Airedale General Hospital
  • Altnagelvin
  • Barnsley NHS Foundation Trust
  • Basildon and Thurrock University Hospitals NHS FT 
  • Bedford Hospital
  • Bradford Royal Infirmary
  • Broomfield Hospital
  • Bupa Cromwell Hospital
  • Central Manchester University Hospitals NHS FT 
  • Chesterfield Royal
  • Christie Hospital
  • City and Sandwell
  • City Hospitals Sunderland
  • Colchester General
  • Conquest Hospital, Hastings
  • Craigavon Hospital
  • Cumberland Infirmary
  • Doncaster Royal Infirmary
  • Dorset County Hospital
  • East Surrey Hospital
  • Eastbourne DGH
  • Epsom and St Heliers NHS Trust
  • Fairfiled General Hospital
  • Freeman Hospital
  • Friarage Hospital
  • Frimley Park Hospital
  • Furness General Hospital
  • George Eliot
  • Glenfield Hospital
  • Gloucestershire Royal & Cheltenham General
  • Great Western Hospital
  • Heartlands, Solihull & Good Hope Hospitals
  • Hinchingbrooke Hospital
  • Imperial College Healthcare NHS trust
  • Ipswich Hospital
  • James Paget University Hospitals
  • John Radcliffe Hospital
  • Kettering General Hospital NHS Trust
  • Kings Mill Hospital
  • Leighton Hospital
  • Liverpool Heart & Chest NHS Foundation Trust
  • Lister Hospital, East and North Herts NHS Trust
  • Medway NHS Foundation Trust
  • Morriston Hospital
  • Musgrove Park Hospital
  • Norfolk & Norwich University Hospital NHS FT
  • North Bristol NHS Trust
  • North Hampshire Hospital
  • North Manchester General Hospital
  • Northwick Park
  • Nottingham University Hospitals NHS Trust
  • Papworth NHS Foundation Trust
  • Pilgrim Hospital, Boston
  • Poole Hospital NHS Foundation Trust
  • Prince Charles Hospital
  • Princess of Wales Hospital
  • Queen Victoria Hospital
  • Queens Hospital
  • Royal Albert Edward Infirmary
  • Rotherham NHS Foundation Trust
  • Royal Berkshire NHS Foundation Trust
  • Royal Blackburn Hospital
  • Royal Bolton Hospital
  • Royal Bournemouth
  • Royal Glamorgan Hospital
  • Royal Gwent hospital
  • Royal Lancaster Infirmary
  • Royal National Orthopaedic Hospital
  • Royal Preston Hospital
  • Royal Sussex County Hospital & Princess Royal Hospital
  • Royal United Hospital Bath
  • Royal Victoria, Belfast City, Mater and Musgrave park
  • Russells Hall Hospital
  • Salford Royal Hospital
  • Scarborough Hospital
  • South Tyneside District Hospital
  • Southend University Hospital Foundation Trust
  • Southport & Ormskirk DG
  • St James's Hospital & Leeds General Infirmary
  • St Marys Hospital
  • St Peters Hospital
  • St. Richard's Hospital
  • Stepping Hill
  • Stoke Mandeville and Wycombe Hospital
  • Tameside General Hospital
  • The James Cook University Hospital
  • The Royal London Hospital
  • The Royal Marsden Hospital
  • The Royal Oldham Hospital
  • Torbay Hospital
  • University Hospital Leicester
  • Ulster Hospital
  • University Hospital Coventry & Warwickshire NHS Trust
  • Wansbeck General Hospital
  • Watford General Hospital
  • West Cumberland Hospital
  • West Middlesex University Hospital
  • West Suffolk Hospital
  • Weston General Hospital
  • Wexham Park Hospital
  • Worcestershire Royal Hospital
  • Worthing Hospital
  • Wythenshawe hospital
  • Yeovil District Hospital
  • York Hospital
  • Ysbyty Gwynedd 

You can view a summary of the results by clicking here.
If your organisation is not listed above and you would like to contribute click on this link to complete the NEWS_NOrF survey.

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