Skip to main content

Main menu

  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us

Clinical Medicine Journal

  • ClinMed Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About ClinMed
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

User menu

  • Log in

Search

  • Advanced search
RCP Journals
Home
  • Log in
  • Home
  • Our journals
    • Clinical Medicine
    • Future Healthcare Journal
  • Subject collections
  • About the RCP
  • Contact us
Advanced

Clinical Medicine Journal

clinmedicine Logo
  • ClinMed Home
  • Content
    • Current
    • Ahead of print
    • Archive
  • Author guidance
    • Instructions for authors
    • Submit online
  • About ClinMed
    • Scope
    • Editorial board
    • Policies
    • Information for reviewers
    • Advertising

Celebrating 10 years of the National Early Warning Score

Sarah Clarke
Download PDF
DOI: https://doi.org/10.7861/clinmed.ed.22.6.1
Clin Med November 2022
Sarah Clarke
Royal College of Physicians
Roles: President
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics
Loading

I'm delighted to introduce this special issue of Clinical Medicine on the National Early Warning Score (NEWS, subsequently updated to NEWS2), which in the 10 years since its release has emerged as one of the RCP's most important clinical initiatives.

NEWS2 has its roots in the 2007 report of the RCP's Acute Medicine Task Force of the time, Acute medical care: the right person, in the right setting – first time.1 At the time, a number of so-called ‘early warning scores’ (EWSs) were already in use across the NHS; they all aimed to provide a safety net for the identification of severely ill and deteriorating patients by tracking simple physiological parameters and triggering a response. However, the variation between them was a serious flaw from the perspective of safety and efficiency, with great potential for communication errors and the need for staff moving between trusts to retrain in the local system each time, as well as a general inconsistency in the detection of and response to acute illness. The report recommended the development of a system-wide EWS that would enable all working in acute care across the NHS to ‘speak the same language’.

The RCP accordingly commissioned a multidisciplinary group to develop a National Early Warning Score (NEWS) and its first iteration was released in 2012. Given the intrinsic benefits of a standardised system, the aim was only to achieve non-inferiority to the other available EWSs, but within a few years it was shown to be the system with the best power to predict deterioration.2 With wider adoption, opportunities for refinement inevitably emerged and NEWS2 came out in 2017.3 At this point, and with the validation of NEWS2 in the detection of sepsis,4 NEWS2 was formally adopted by the NHS and has subsequently been embedded into the CQUIN framework.

This special issue is edited by Professor Bryan Williams, the chair of the NEWS and NEWS2 development groups and its great champion over the past 10 years. Professor Williams has curated a broad collection of perspectives looking at NEWS2 in the round. Starting with a review of the history of NEWS,5 other areas of focus include sepsis,6 confusion and delirium in the older patient,7 hypercapnic respiratory failure8 and COVID-19;9 the role of NEWS2 in out-of-hospital settings, such as ambulance and emergency services;10 how to integrate NEWS2 digitally;11 and, importantly, the e-learning programme that has played no small part in the success of NEWS2.12 A very helpful commentary reviews what NEWS2 is for and (importantly) what it isn't for,13 and Celia Ingham Clark, the NHS's medical director for clinical effectiveness, outlines the journey of NEWS2 towards full adoption in the NHS14 (not to mention inspiring the development of similar early warning systems for paediatric and maternity services, PEWS and MEWS). Together with Professor Williams, I would like to thank all the authors for contributing to the issue.

NEWS2 has driven a step-change improvement in safety and clinical outcomes for acutely ill patients in our hospitals and this is a huge achievement that the RCP, and specifically Professor Williams and his collaborators, can be rightly proud of. It is a true exemplar of the clinically driven leadership that the RCP can provide.

  • © Royal College of Physicians 2022. All rights reserved.

References

  1. ↵
    1. Royal College of Physicians
    . Acute medical care: the right person, in the right setting – first time. RCP, 2007.
  2. ↵
    1. Smith GB
    , Prytherch DR, Meredith P, Schmidt PE, Featherstone PI. The ability of the National Early Warning Score (NEWS) to discriminate patients at risk of early cardiac arrest, unanticipated intensive care unit admission, and death. Resuscitation 2013;84:465–70.
    OpenUrlCrossRefPubMed
  3. ↵
    1. Royal College of Physicians
    . National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHS. RCP, 2017. Available from www.rcplondon.ac.uk/projects/outputs/national-early-warning-score-news-2 [Accessed 1 November 2022].
  4. ↵
    1. Corfield AR
    , Lees F, Zealley I, et al. Utility of a single early warning score in patients with sepsis in the emergency department. Emerg Med J 2014;31:482–7.
    OpenUrlAbstract/FREE Full Text
  5. ↵
    1. Williams B
    . The National Early Warning Score: from concept to NHS implementation. Clin Med 2022;22:499–505.
    OpenUrlAbstract/FREE Full Text
  6. ↵
    1. Inada-Kim M
    . NEWS2 and improving outcomes from sepsis. Clin Med 2022;22:514–7.
    OpenUrlAbstract/FREE Full Text
  7. ↵
    1. Vardy E
    . National Early Warning Score (NEWS) 2 and the older person. Clin Med 2022;22:522–4.
    OpenUrlAbstract/FREE Full Text
  8. ↵
    1. Juniper M
    . NEWS2, patient safety and hypercapnic respiratory failure. Clin Med 2022;22:518–21.
    OpenUrlAbstract/FREE Full Text
  9. ↵
    1. Williams B
    . Evaluation of the utility of NEWS2 during the COVID-19 pandemic. Clin Med 2022;22:539–43.
    OpenUrlAbstract/FREE Full Text
  10. ↵
    1. Tavare A
    , Gibson A, Barker R. NEWS2 in out-of-hospital settings: the ambulance and the emergency department. Clin Med 2022;22:525–9.
    OpenUrlAbstract/FREE Full Text
  11. ↵
    1. Subbe CP
    , Bramley R. Digital NEWS? How to amplify the benefits of NEWS in a digital health care system. Clin Med 2022;22:534–8.
    OpenUrlAbstract/FREE Full Text
  12. ↵
    1. Blackwell N
    . The development and introduction of a national e-learning programme to support the dissemination of NEWS2. Clin Med 2022;22:530–3.
    OpenUrlAbstract/FREE Full Text
  13. ↵
    1. Welch J
    , Dean J, Hartin J. Using NEWS2: an essential component of reliable clinical assessment. Clin Med 2022;22:509–13.
    OpenUrlAbstract/FREE Full Text
  14. ↵
    1. Ingham Clark C
    . NEWS and the NHS. Clin Med 2022;22:506–8.
    OpenUrlFREE Full Text
Back to top
Previous articleNext article

Article Tools

Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Citation Tools
Celebrating 10 years of the National Early Warning Score
Sarah Clarke
Clinical Medicine Nov 2022, 22 (6) 498; DOI: 10.7861/clinmed.ed.22.6.1

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Celebrating 10 years of the National Early Warning Score
Sarah Clarke
Clinical Medicine Nov 2022, 22 (6) 498; DOI: 10.7861/clinmed.ed.22.6.1
del.icio.us logo Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • References
  • Info & Metrics

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • Formalised curiosity
  • COP27 Climate Change Conference: urgent action needed for Africa and the world
Show more Editorial

Similar Articles

FAQs

  • Difficulty logging in.

There is currently no login required to access the journals. Please go to the home page and simply click on the edition that you wish to read. If you are still unable to access the content you require, please let us know through the 'Contact us' page.

  • Can't find the CME questionnaire.

The read-only self-assessment questionnaire (SAQ) can be found after the CME section in each edition of Clinical Medicine. RCP members and fellows (using their login details for the main RCP website) are able to access the full SAQ with answers and are awarded 2 CPD points upon successful (8/10) completion from:  https://cme.rcplondon.ac.uk

Navigate this Journal

  • Journal Home
  • Current Issue
  • Ahead of Print
  • Archive

Related Links

  • ClinMed - Home
  • FHJ - Home
clinmedicine Footer Logo
  • Home
  • Journals
  • Contact us
  • Advertise
HighWire Press, Inc.

Follow Us:

  • Follow HighWire Origins on Twitter
  • Visit HighWire Origins on Facebook

Copyright © 2021 by the Royal College of Physicians