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the recording of physiological parameters, such as blood pressure, pulse etc. has been reordered to align with the Resuscitation Council (UK) A,B,C,D,E sequencethe ranges for the boundaries of each parameter score are now shown on the chartthe chart has a dedicated oxygen section (SpO2 Scale 2) for use in patients with hypercapnic respiratory failure (usually due to COPD) who have clinically recommended oxygen saturation of 88–92%the section of the chart for recording the oxygen delivery rate of (L/min) and method/device for supplemental oxygen delivery has been improved

LAUNCH OF NEWS2Starting week commencing 4th March 2019 in Community Hospitals

WHAT ARE THE BENEFITS OF

USING NEWS2 IN THE

COMMUNITY?

Following evaluation of National Early Warning Score (NEWS), the scoring chart has been updated to become NEWS2 as follows:

WHY HAS NEWS2 BEEN LAUNCHED?

NEWS2 can facilitate communication at the interfaces of care such as when requesting ambulance transfer or hospital assessment. Without communicating full physiological observations (that ambulance call handlers and hospital colleagues can use to calculate the NEWS2 from), colleagues find it extremely difficult to ascertain who the most sick and most in need are, particularly when the system is extremely busy. NEWS2 should be considered as part of the wider assessment and could support colleagues to identify deterioration early and prioritise resources in times of surge.

NEWS2 can empower staff to be listened to if they have concerns about a patient.For people in care homes, knowing their baseline NEWS2 score may help a doctor who has to assess them acutely to determine whether they are worse than baseline or not (especially if this is not their usual doctor). A NEWS2 assessment might also help healthcare professionals decide that a patient doesn’t need an emergency referral, and if the person re-presents a few hours or days later, the healthcare professional seeing the patient for the second visit can use the measurement alongside their clinical judgment to see if the score has changed since the person was last assessed.

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For more information please contact: Ceri Adamson, Clinical Lead for Quality.

email: ceri.adamson@nhs.net

The use of NEWS2 is encouraged (as an adjunct to clinical assessment but not a replacement) to support the assessment of physical deterioration of adults in community and primary care settings. Professionals can use NEWS2 to communicate vital signs data in a common language. The thresholds provide a guide to the severity of the illness. The earlier a complete set of observations is done (e.g. in the patient’s home or GP surgery), the sooner a patient can be placed on a track and trigger score; and improvement or deterioration against this baseline can be detected. A number of general practices (West of England; Liverpool and Wessex) have found the use of NEWS and NEWS2 to be helpful as an adjunct to

decision making; as a prompt to do a complete set of observations and when communicating with the rest of the healthcare pathway about deteriorating patients. This enables colleagues in other settings (e.g. ambulances, emergency departments, acute medical units) to plan, prioritise and place patients safely and appropriately. It is particularly important to document and hand over complete physiological observations when discussing or transferring potentially unwell patients across healthcare settings and between shifts. Community organisations that have adopted this have found that NEWS2 improves the reliability of this process.

How can NEWS2 be used in the community?

NEWS2 Observation Chart

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NEWS2 Clinical Response

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