Understanding and Responding to NEWS2 Scores

Introduction

Learn how to interpret NEWS2 scores and take appropriate actions based on the resident's condition.

Assessing NEWS2 Scores

• Consider Normal Reference Score: Always compare the resident's total NEWS2 with their usual reference score.

NEWS2 Score of Zero

• Observation: Person appears stable; they can stay at home.
• Escalation: If any clinical or personal concerns arise, escalate the situation.
• Monitoring: Conduct observations at least every 12 hours or until concerns are resolved.

NEWS2 Score of One

• Review: Immediate senior staff review required.
• Escalation: If concerned, escalate the situation.
• Observations: Repeat observations within 6 hours.
• GP Review: If observations remain elevated with no clear cause, arrange a GP review within 24 hours.
• Worsening NEWS: If NEWS worsens, follow the appropriate escalation process.

NEWS2 Score of Two

• Immediate Review: Immediate senior staff review required.
• Escalation: If there's no improvement within 2 hours or if concerned, escalate the situation.
• Observations: Repeat observations within 2 hours, then every 6 hours.
• GP Assessment: Seek a GP telephone assessment within 2 hours and re-assessment within a further 6 hours if no improvement.
• Worsening NEWS: If NEWS worsens, follow the appropriate escalation process.

NEWS2 Score of Three to Four

• Repeat Observations: Repeat observations within 30 minutes.
• Urgent GP Review: If observations equal a NEWS score of 3 or more, seek urgent GP telephone or face-to-face review within 2 hours.
• Worsening NEWS: If NEWS worsens, follow the appropriate escalation process.

NEWS2 Score of Five to Six

• Immediate Clinical Review: Immediate clinical review and advice required.
• GP Referral: Refer to a GP using the surgery bypass number or contact NHS 111 if out of hours.
• Urgent Hospital Transfer: Urgent transfer to a hospital within 1 hour may be necessary.
• Continuous Monitoring: Continuously monitor the patient, repeating observations every 15 minutes.

NEWS2 Score Over Seven

• Urgent Hospital Transfer: Immediate transfer to a hospital may be required.
• Monitoring and Documentation: Monitor the patient and follow the call handler's guidance. Ensure documentation of the transfer process.
• Admission Plan: Admission to the hospital should align with any agreed and documented plan of care.