The Use of the National Early Warning Score (NEWS) in Mental Health

The National Early Warning Score (NEWS) is an evidence–based tool which assigns scores on
physiological parameters on an aggregated basis to identify patients whose health is
deteriorating. It was adopted in NHS Greater Glasgow and Clyde (NHSGGC) Acute Services in
2012.

A proposal to implement NEWS in Mental Health Services (MHS) was tabled by Dr J.Whyte
and Dr A.Ganai at the Mental Health Services Older Peoples Care Governance Group in 2016
and it was agreed to test NEWS in the Cuthbertson Older Adult Ward (Gartnavel Royal
Hospital). A short working life group led by Stephen McGinness, Professional Nurse Advisor
for South Glasgow and East Renfrewshire, and supported by Brian Rowan and Karyn
Hamilton, Practice Development Nurses Gartnavel Royal Hospital developed a NEWS Mental
Health Services Action Reference Tool to guide staff. The test of NEWS utilisation and
compliance was carried out from 19th September 2016 – 31st October 2016.

The recommendations from the test ward informed the proposed implementation plan,
these included:

 NEWS should be implemented in a phased approach in Mental Health Services

 Staff should be supported in gaining competencies (training)
 The audit tool to monitor compliance of NEWS should be reviewed to reflect use in
mental health services (with associated reference tool)
 Audit should be carried out to monitor compliance following implementation

The implementation plan sets out the proposal and detail to begin implementation of NEWS
within older adult wards in Mental Health Services, with timescales of September 2017 –
January 2018. This will be evaluated at the end of the implementation period to inform the
implementation of NEWS in other inpatient areas. Practice Development Nurses will deliver
face to face training in the use of the tool and registered Nursing staff will also have to
complete the specific NEWS online training module. This will be confirmed with the Senior
Charge Nurse of each ward before Nursing staff begin to use the tool. Local medical staff will
be informed when each ward is ready to commence use.

The implementation of this tool for patients in mental health wards ensures the initial
assessment and potential escalation of actions will be on parity with the care patients would
receive in the acute setting.

Further reading:
1. The Academy of Medical Royal Colleges Report ‘Improving the Physical Health of
Adults with Severe Mental Illness: essential actions OP100’ (2016)
2. Royal College of Physicians. National Early Warning Score (NEWS) standardising the
assessment of acute illness severity in the NHS (2012).

For more information contact

Stephen McGinness Stephen.McGinness@ggc.scot.nhs.uk
Professional Nurse Advisor
August 2017