National Early Warning Score

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A case study describing actions by West of England patient safety collaborative (PSC) to standardise use of National Early Warning Score (NEWS) across all acute trusts in the West of England.

What is the National Early Warning Score?

The NEWS is a structured observation to recognise deterioration. Acute providers are required to standardise their approach to deterioration but many organisations have been slow to adopt NEWS and still use regional or non-standardised versions.

NHS England with support from NHS Improvement has endorsed its national adoption and is aiming for all acute and ambulance settings to be using it by March 2019 to reduce the number of patients who deteriorate while in hospital. This has the potential to save over 1,800 lives a year.

As part of the care of the deteriorating patient national workstream, in 2018/19 all PSCs are:

  • mapping the extent to which NEWS has been implemented in their region
  • agreeing plans for the most effective and reliable adoption of NEWS within their region.

What the PSC did

In 2015, West of England PSC started a three-year project to standardise use of NEWS across all acute trusts in the West of England AHSN region and to extend the use of NEWS scores into pre-hospital care. It used the Institute for Health Improvement’s (IHI’s) breakthrough collaborative approach to influence change across a whole system. Collaborative events were held every six months and more task groups more frequently as part of pre-existing forums. Organisations were given educational resources and a toolkit was developed to support the implementation of NEWS.

Impact

All acute trusts, community services, mental health providers and prisons in the region as well as the ambulance trust, have introduced NEWS into their electronic patient record. NEWS is also used in a range of primary care settings.

From 2014/15 to 2016/17 – the first two years of the project – ‘suspicion of sepsis’ admissions in the West of England AHSN region rose from 61,000 to 69,000, and mortality rates dropped from by 13%. By October 2017, this region had the lowest mortality rate from ‘suspicion of sepsis’ in England.

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