NEWS2 score for assessing the patient at risk of deterioration

The RCGP supports the use of physiological measurements in a general practice setting for all patients at risk of deterioration.

More research evidence on the use of NEWS2 in a primary care setting is required before the RCGP can consider recommending its widespread uptake in a general practice.

Sudden acute deterioration in health can occur as a result of a wide variety of causes across all systems, including infection, cardiovascular issues, haemorrhage and embolism amongst others. These high-consequence pathological conditions can present in the community, and it is important that they are recognised and managed appropriately in general practice.

The unwell patient at risk of deterioration presenting in general practice requires the clinician to:

  • Identify relatively unusual but well recognised acute presentations
  • Assess the patient appropriately
  • Respond and provide interventions (where appropriate) to start treatment or stabilise the patient
  • Effectively communicate their assessment to achieve a timely response from colleagues within the health care system, for example, ambulance switchboard, paramedic and secondary care teams.

In order to standardise practice, stratify risk, and aid communication between services, NHS England have recommended the National Early Warning Score (NEWS2) as the universal scoring system to use across the NHS within ambulance and secondary care services for the patient at risk of deterioration. This was communicated as a Patient Safety Alert and was implemented in March 2019. It did not mandate its use within general practice but noted that work was taking place to identify evidence within the community and primary care. There are calls for GPs to use NEWS2 scores as part of their clinical assessment of acutely deteriorating patients and particularly those requiring inpatient care and ambulance transportation.

The full position statement can be downloaded below.

Clinical Policy

Position Statement: The use of the NEWS2 score for assessing the patient at risk of deterioration (799 KB PDF)

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