The National Early Warning Scoring system

Published: 10 December 2012

Critical care outreach and acute care teams have long encouraged the use of early warning scoring systems to enable a more timely response to and assessment of acutely ill patients. Indeed, optimising organisational delivery of safe, equitable and quality care for all acutely unwell, critically ill and recovering patients, irrespective of location or pathway, has been a life’s work for many clinical champions of outreach, including a significant portion of ours.

When we were asked in 2009 to join the National Early Warning Score (NEWS) system development and implementation group, our initial thoughts were “can this really be done” and “will we ever reach consensus on a single standardised national early warning scoring system”?

After much hard work, debate and consultation with clinical colleagues with a wealth of expertise in this area, we believe that this first iteration of NEWS and the accompanying web-based learning package provides a key step forward towards standardisation of assessment, monitoring and tracking of acutely and critically ill patients. It also enforces the necessity of early review by clinical staff with the necessary competency requirements and the availability of the clinical team undertaking the review. 

With reference to the latter, the process of developing a NEWS system and an appropriate clinical response has further galvanised the often overlooked contribution of skilled critical care outreach and acute care teams. This document therefore serves as a reminder that the availability of these teams 24 hours a day, seven days a week should be integral to organisational patient safety strategies.

The next steps are to embrace and encourage the widespread use of NEWS with a view to generating a robust evidence base which can be used to evaluate effectiveness and drive future refinement if required. 

Finally, we would like to acknowledge and thank clinical colleagues and peers who have engaged with this project with enthusiasm and commitment. We are indebted to their clinical wisdom and insight into the topic and in particular the time they have taken to offer constructive criticism and comment.

Lesley Durham RGN MSc - National Outreach Forum
Rachel Binks RGN MHSc - Royal College of Nursing