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. NEWS2 is the latest version of the National Early Warning Sore, developed by The Royal College of Physicians. Find out more.
Currently, all 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 NEWS2, 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!’) 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.
To see a summary of the project in the form of a poster, including results and challenges click here.
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. It is available free as a support tool to implement NEWS in your organisation.
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 free toolkit for implementing the ED Safety Checklist.
NEWS in community settings
We have teamed up with our community providers 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.
A next step for our NEWS work is to expand its use into wider community settings. This includes a focus on people with learning disabilities. We have established the West of England Learning Disabilities Collaborative, made up of professionals, experts by experience, families and carers. By applying our learning from the region-wide rollout of NEWS, we aim to reduce premature mortality and improve health outcomes for people with learning disabilities.
Use of NEWS is being promoted in care homes across the West of England, through our SAFER (Safety & Autonomy For Every Resident) Care Homes Collaborative.
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. We also have a template available in SystemOne, please email email@example.com for more information.
Tying all of this work together, we have run various collaborative cross-sector learning set events with hundreds of attendees from healthcare providers across the region and beyond.
BMJ Emergency Medicine Journal: Distributions of the National Early Warning Score (NEWS) across a healthcare system following a large-scale roll-out: https://emj.bmj.com/content/early/2019/03/06/emermed-2018-208140
Resuscitation: Can early warning scores identify deteriorating patients in pre-hospital settings? A systematic review: https://www.sciencedirect.com/science/article/pii/S0300957218308190
BMJ Open: Using the National Early Warning Score (NEWS) outside acute hospital settings: a qualitative study of staff experiences in the West of England: https://bmjopen.bmj.com/content/8/10/e022528.full
If you would like to get involved or want more information, please contact the team at firstname.lastname@example.org.
- Let the numbers do the talking: NEW event 2 years on: 16 March 2017, Bristol.
- 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