Evidence for National Early Warning Scores in primary care

GPs make decisions every day about whether a patient is deteriorating and needs to be admitted to hospital urgently. Early warning scores have been developed to identify patients who need urgent treatment.

They are routinely used in hospitals and although there isn’t much clear evidence to support their use, there is growing interest in using early warning scores in other locations such as GP surgeries, prisons and ambulance services. The most commonly used early warning score across the NHS is the ’national early warning score’ or NEWS.

NEWS is a simple scoring system of seven measurements, which are usually taken when patients are admitted or being monitored in hospital:

1. Respiratory rate
2. Oxygen saturation
3. Temperature
4. Systolic blood pressure
5. Heart rate
6. Level of consciousness
7. Any supplemental oxygen

Each of these is scored from 0 to 3 and they are added together to give an overall score. Higher scores suggest that a patient is seriously ill. Measurements can be repeated to see how the patient is doing. If their score is lower, this suggests they are getting better, while an increase shows they are getting worse.

This project looked at whether there is evidence that early warning scores can predict outcomes in patients in hospitals and other healthcare settings.