Sepsis Early Warning Score Adopted in UK

Peter Russell

December 20, 2017

Every NHS hospital trust in England will be asked to adopt a new clinical system for assessing acutely ill patients.

Almost 2,000 deaths each year could be prevented if consistent checks are made, according to the NHS.

The National Early Warning Score (NEWS), developed by the Royal College of Physicians (RCP) in 2012, has now been formally endorsed by NHS England.

It is set to become the early warning system for identifying patients who are becoming seriously ill, including those with sepsis.

Sepsis

Sepsis is a serious complication of infection. It occurs when the body's immune system response to infection results in damage to the body's own tissues and organs.

Sepsis is a serious complication of infection. It occurs when the body's immune system response to infection results in damage to the body's own tissues and organs.

Sepsis can lead to shock and organ failure if not recognised in its early stages and treated promptly.

There are around 123,000 cases of sepsis in England each year. 

Early Warning System

The new standardised approach would mean that NHS hospital staff use a scored assessment of a how ill a patient is becoming.

The score is designed to help healthcare professionals determine whether or not a patient is deteriorating and may need extra care. These key measures are:

  • Breathing rate

  • Pulse rate

  • Blood pressure

  • Temperature

  • Level of consciousness

  • Oxygen saturation

A low score would prompt an assessment by a registered nurse, whereas a high score would lead to an emergency assessment by a critical care team and the likelihood of specialist care.

The system has been adopted by the US Navy as well as health authorities in Europe and India. It is estimated that the NEWS is now being used in over 70% of NHS hospitals. However, NHS England wants to see the system also in place for emergency and ambulance care by 2019.

Saving Lives

The quality standard builds on a set of NICE recommendations. These state that health professionals should look for specific symptoms if they think someone has sepsis.

Changes to sepsis treatment were promised after a report from the National Confidential Enquiry into Patient Outcome and Death found delays in identifying sepsis in 36% of cases.

Professor Bryan Williams, chairman of the NEWS Development Group and RCP clinical lead for NEWS, says in a statement: "We developed the NEWS to save lives in the NHS.

"The uptake and impact of the NEWS over the past 5 years has been extraordinary, and beyond even the most optimistic expectations, especially considering that there was no national incentive or directive to implement it.

"The majority of NHS hospitals are now using the NEWS, and over 150,000 NHS staff have voluntarily completed the online NEWS training and accreditation programme."

Sir Bruce Keogh, NHS England's medical director, says in a statement: "Air Traffic Control systems around the world use common standards and language to prevent disasters and the NHS, with the safety of millions of patients every year at stake, should be no different."

Dr Ron Daniels, chief executive of the UK Sepsis Trust, comments in an emailed statement: "This is a major step forward and the national roll out of the score has the potential to save thousands of lives.

"It's vital that healthcare professionals have access to tools for diagnosing and treating sepsis that are consistent across the NHS."

SOURCES:

The Royal College of Physicians (RCP)

NHS England 

UK Sepsis Trust

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