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Critical Care

Open Access

Abandoning the National Early Warning Score in our district general hospital

  • B Mylrea Lowndes1,
  • M Mercer1 and
  • H Robinson1
Critical Care201418(Suppl 1):P61

Published: 17 March 2014


Early Warning Scores (EWS) are used in UK hospitals to identify patients who are acutely unwell or needing urgent review. The National EWS (NEWS) [1] was implemented in our institution and led to a noticeable increase in the numbers of patients being triggered for escalation of medical care, although clinically this was thought unwarranted. This led to a potentially dangerous lack of faith in the NEWS by clinical staff. We assessed whether it was safe to move to VitalPAC™ EWS (ViEWS), a commercially available electronic EWS [2]


All patients scored as 'high risk' by NEWS (with a score of 6 or more) in a snapshot audit of patients in our 500-bed acute district general hospital were identified and reviewed clinically. All of these patients were then recategorised using ViEWS. The clinical safety of this recategorisation was then assessed.


Forty-six patients were identified in our hospital at the time of the snapshot as being high risk according to NEWS. After recategorising this cohort of patients using ViEWS, 36 were classified as high risk (in this instance meaning a score of 5 or more). Subjectively the authors did not have any clinical concerns created by moving 10 patients out of the high-risk classification.


ViEWS is more specific without being less sensitive. We have replaced NEWS with ViEWS and feel that this is clinically safe.

Authors’ Affiliations

Torbay Hospital, Torquay, UK


  1. National Early Warning Score (NEWS). Standardising the Assessment of Acuteillness Severity in the NHS. London: Royal College of Physicians; 2010, 81: 932-937. []
  2. Prytherch D, et al.: Resuscitation. 2010, 81: 932-937. 10.1016/j.resuscitation.2010.04.014View ArticlePubMedGoogle Scholar


© Mylrea Lowndes et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.