Anne Pullyblank, Clinical Director for the West of England Patient Safety Collaborative, looks back at the first year of the Safer Care through Early Warning Scores programme, which was launched in March 2015.
“Our aim is to use the National Early Warning Score (NEWS) at every handover of care. Wouldn’t it be great if the NEWScore was communicated along the entire pathway for the acutely unwell patient? Sick patients might be recognised sooner (a colleague of mine compares this to ‘Where’s Wally?’!), while NEWS can trigger earlier recognition and treatment of sepsis.
“More importantly, by changing our system response, the vision is to get the sickest patient treated at the right time, in the right place, by the right clinician.
“We are making progress faster than expected with this project. This is because people believe in it.
“All six acute trusts in the West of England have standardised to NEWS, which on its own is a tremendous achievement.
“NEWS now features in the new ambulance service electronic patient record and it has been introduced to some GP systems. We are spreading the use of an ED safety checklist, which again includes the use of NEWS.
“NEWS has been adopted by our community colleagues, prisons and mental health trusts, helping to escalate the care of sick patients between health providers. And we are collaborating with researchers to systematically evaluate our work.
“The work is happening not because of a government diktat or because we are being paid to do it, but because dedicated people across a health system believe this will make patient care safer.
“The objective is to reduce mortality from sepsis, rescue acutely unwell patients and ultimately treat some patients at home appropriately leading to admission avoidance.
“Having the right patient treated at the right time, in the right place, by the right person will improve flow across the system – saving money, bed days and most importantly lives.”
Safer care through early warning scores: the lowdown
Too often, healthcare providers in different sectors do not speak the same ‘language’ at the interfaces of care, resulting in a lack of consistency in detecting and responding to acute illness. In the West of England, our providers have agreed to implement a single common approach to identifying and communicating about deteriorating patients.
We are systematically rolling out the National Early Warning Score (NEWS) in all healthcare settings, supported by standardised communication to share clinical information and using quality improvement approaches and techniques.
We have achieved active cross-sector engagement from all NHS service providers and commissioners. All six acute trusts now use NEWS, as do both mental health trusts and the ambulance trust. There are clear strategies and programmes of work to spread the use of NEWS in community and primary care over the next 12 months and ensure a NEWScore is communicated at all handovers of care in all sectors.