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Hospitals urged to streamline system for identifying seriously ill patients

Almost 2,000 lives could be saved each year if all hospitals adopted the National Early Warning Score system for spotting which patients are seriously ill, says NHS England


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Almost 2,000 lives could be saved each year if all hospitals adopted the same system for spotting which patients are seriously ill, officials say.

Hospitals across England have been urged to use a standardised system to identify acutely ill patients, including those with sepsis.

NHS England cited the example of air traffic control safety standards being the same across the world, and said the health service should be no different.

It is hoped that using a standardised warning system to spot seriously ill patients would mean nurses and doctors who move between trusts are using a consistent set of measures for diagnosing patients.

Based on key measures

The National Early Warning Score (NEWS) system, developed by the Royal College of Physicians, determines whether a patient needs care from a nurse, ward doctor or critical care team.

Patients are given a score based on a series of key measures:

  • Breathing rate.
  • Pulse rate.
  • Blood pressure.
  • Temperature.
  • Level of consciousness.
  • Oxygen saturation.

Plotted on chart

The results are plotted on a NEWS chart, which gives a score for each measure. The combined number shows the level of clinical care needed and the risk of deterioration.

A low score of 1-4 results in an assessment by a registered nurse, a medium score of 5-6 prompts an urgent review by an acute clinician such as a ward-based doctor, and a high score of seven or more leads to an emergency assessment by a critical care team and the likely transfer of the patient to a high-dependency unit.

NHS England has urged every hospital and ambulance service to adopt the system by 2019. Only seven in 10 currently do so.

If every organisation used the system 2,000 lives and 627,000 bed days could be saved every year, NHS England estimates.

Warning signs missed

NHS England national medical director Sir Bruce Keogh said: 'Air traffic control systems around the world use common standards and language to prevent disasters and the NHS, with the safety of millions of patients every year at stake, should be no different.

'If staff move between hospitals and end up speaking at cross purposes, warning signs are missed and patient care can be compromised.

'I want to see every hospital in the country using the NEWS approach by 2019 as we continually strive to make sure the NHS delivers the highest standards of care possible.'

Royal College of Physicians' president Jane Dacre said: 'Over the next year NEWS will become the default early warning score for NHS Trusts and ambulances.

'Patients will benefit from its implementation, and staff will benefit from not having to learn a new score each time they join a new trust.'


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