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Early warning track and trigger

As a common standard, all Trusts in the Network are expected to achieve compliance with NICE (CG50) requirements for early detection and action on critical illness in ward patients (‘track and trigger’). This must be agreed and implemented at Trust Executive and Board level, and compliance is included in the Network Quality Measures.

NICE clinical guideline for recognition of and response to Acutely ill patients in hospital (CG50)

Further guidance, implementation tools and resources are available at

The Royal College of Nursing, Royal College of Physicians , Intensive Care Society, National Outreach Forum and Royal College of Anaesthetists (see links to right) have spent a number of years developing a standardised NHS early warning scoring system (NEWS), which can be used to help identify patients whose condition is deteriorating and trigger a response. This was published in July 2012. An update has been released in December 2017 as NEWS 2.

National Early Warning Score (2012)

NEWS observation chart (with explanatory notes)

NEWS clinical response outline (with explanatory notes)

NEWS thresholds and triggers (with explanatory notes)

Some Network members piloted the draft “NEWS” in selected clinical areas, and feedback from those trials was shared following reporting to local critical care delivery groups. Further roll out took place at all other sites in North West London. The latest NEWS 2 will be discussed in the New Year about any Network wide strategy that might be useful to support implementation locally.

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