The West of England Patient Safety Collaborative has developed a programme, delivered by the West of England AHSN, encouraging the use of a single early warning score – the National Early Warning Score (NEWS) – across the region.
Currently, the acute trusts, out-of-hours GP services, mental health trusts, community service providers and clinical commissioning groups (CCGs) have all signed up to support the adoption and spread of NEWS, and communicating this score at the interfaces of care across the system.
The use of early warning scores is being recommended in primary and community care settings. The National Confidential Enquiry into Patient Outcome and Death report in November 2015 (‘Just Say Sepsis!’) has most recently argued that an early warning score should be used in both primary and secondary care wherever sepsis is suspected. Early warning scores are increasingly becoming part of the lexicon for communication about physiology between all health care providers, enhancing and focusing the handover of technical information about patients, especially those at risk of deterioration.
NEWS in practice
We now have a number of examples of patient stories from across the region where NEWS has been used to assess and trigger responses across patient pathways and ultimately improving outcomes for those patients.
One of these examples was a patient in North Somerset who visited his GP with cellulitis but felt very poorly. The GP used NEWS to assess that the patient was acutely unwell and needed rapid treatment. NEWS was used to track the patient’s condition from primary care, into the ambulance and into the Emergency Department and clearly showed he was deteriorating. This patient had sepsis but thanks to the early detection of his condition in primary care, it was treated within five hours of seeing his GP and he made a quick and full recovery.
We have produced a short film to tell this story.
NEWS in acute settings
In order to achieve our aims we have adopted a breakthrough collaborative model. Our acute providers have all committed to using NEWS as the early warning score of choice. To date, the West of England AHSN has supported two acute trusts (North Bristol NHS Trust and University Hospitals Bristol NHS Foundation Trust) to convert to NEWS through a dedicated education and training manager, who has helped produce a NEWS Implementation Toolkit.
NEWS in emergency departments
We are supporting the roll-out of the Emergency Department Safety Checklist, piloted at University Hospitals Bristol NHS Foundation Trust, which includes the requirement to take hourly observations and calculate NEWScores to track patient acuity in ED. We have also developed a toolkit for implementing the ED Safety Checklist.
NEWS in community settings
We have teamed up with our community providers, through our Community Forum, supporting them with identification of the deteriorating patient in a community setting. We are working with each CCG to help raise the profile of NEWS across the different settings and are producing a suite of resources for GPs to support use of NEWS in pre-hospital settings. We have some brilliant examples of NEWS being used in practice.
NEWS in primary care
If you would like a simple information sheet explaining what NEWS is and why it’s a relevant tool for primary care download it here.
If you are an EMIS user you have access to a NEWS template. This video explains how to set up: watch here.
Tying all of this work together, we have run three collaborative cross-sector learning set events over the past year with more than 100 attendees from healthcare providers across the region and beyond.
NEWS on your phone
These links are provided for information only.
If you would like to get involved or want more information, please contact the team at firstname.lastname@example.org.
- The deteriorating patient: handover to me, handover to you: 15 September 2016, Bristol
- Share the News – Safer Care Through Early Warning Scores Workshop: 10 March 2016, Swindon
- Safer Care Through Early Warning Scores: 17 September 2015, Bath
- Patient Safety Workshop – A Single Early Warning Score for the West of England: 5 March 2015, Bristol