What’s behind the NEWS? National Early Warning Scores in primary care

Everyone is talking about the NEWS — National Early Warning Scores.1 GPs will have noticed that ambulance call handlers are now routinely asking health professionals for a patient’s NEWS,2 and some areas are encouraging routine use of this scoring system in the community.3 So why has this happened and what is the evidence to support its use in the community? Should GPs be adopting NEWS or NEWS2 (an updated version that puts a greater emphasis on new onset confusion and recognises alternative oxygen saturations for people with respiratory failure) as part of their usual practice? Early warning scores (EWS), most recently NEWS2, have been used in hospitals for several years. In secondary care settings, they are primarily used by members of the team recording routine physiological observations in order to identify patients who are deteriorating clinically. The universal use of a common scoring system allows clinical information to be communicated efficiently across departments, clinical settings, and between clinical colleagues. Its usefulness as a common language, combined with the drive to identify sepsis early, have contributed to the widespread adoption and acceptance of NEWS2 in secondary care. Given the widespread use and acceptance in hospitals, it is only natural to consider whether it would also be helpful to use NEWS2 in the community. If paramedics, GPs, district nurses, and nursing home staff were all using the same system, then the benefits of this ‘common language’ in communicating physiological risk should help to identify those patients at greatest risk of deterioration and allow the prioritisation of resources accordingly. In …