New approach to NHS clinical assessment

NHS England is asking every hospital trust to adopt the Royal College of Physicians’ new clinical assessment system, also being targeted by the US navy, that could save almost 2,000 lives and 627,000 bed days every year.

The National Early Warning Score (NEWS), produced by the Royal College of Physicians, is backed by the Royal College of Emergency Medicine, NHS Improvement, the Association of Ambulance Chairs and Sir Bruce Keogh, National Medical Director for NHS England.

The system was developed with the aim of creating a standardised approach to clinical assessment across the country.

It is estimated that the NEWS is now being used in over 70 per cent of trusts but NHS England is setting the goal of having the system in place across every acute and ambulance setting by 2019.

Having the NEWS adopted as a standard system will mean NHS staff who move between trusts are using a consistent set of measures for diagnosing patients.

Under the system, patients are assessed on a series of key measures, including breathing rate, pulse rate, blood pressure, temperature, level of consciousness and oxygen saturation.

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

A low score of between 1-4 would lead to an assessment by a registered nurse; a medium score of between 5-6 would prompt an urgent review from an acute clinician; and a high score of seven of more would see an emergency assessment by a critical care team and a likely patient transfer to a high dependency unit.

A cross-system working group has been established, and will develop and oversee a plan to achieve the ambition The group is chaired by Celia Ingham Clark, consultant surgeon and NHS England Medical Director for Clinical Effectiveness.