Health boards and trusts throughout NHS Wales have achieved the implementation of standardised Early Warning Scores across all age groups and in acute maternity services.
All seven Welsh health boards have successfully introduced the National Early Warning Score 2 (NEWS2), Paediatric Early Warning Score (PEWS), Neonatal Early Warning Trigger and Track (NEWTT2), and Maternity Early Warning Score (MEWS), whilst Velindre University NHS Trust and the Welsh Ambulance Service Trust have implemented NEWS2
The Early Warning Score tools provide uniform approaches based upon vital signs observations, for healthcare professionals to identify acute deterioration, and to be able to communicate the level of acuity using a consistent language. They form part of broader systems for preventing, identifying and rapidly responding to instances of patients becoming increasingly unwell.
Through the Acute Physical Deterioration Implementation (APDI) Network, the Critical Care, Emergency Medicine and Trauma Network, the Maternity and Neonatal Strategic Network and the Child Health Network, NHS Wales Performance and Improvement (NHSWPI) has supported implementation of the scores following the direction of their use in Welsh Health Circulars published in September and October 2024, and February 2025.
Dr Babu Muthuswamy, Clinical Lead, Critical Care, Emergency Medicine and Trauma Network, said: “The implementation of standardised early warning scores across all ages and maternity settings is a landmark moment for health care providers in Wales, as it provides a common language for healthcare professionals to communicate and plan the care of acutely deteriorating patients. It provides the foundation to build and improvise other patient safety programmes, including the Call 4 Concern in Wales.
“This, by no means is an easy feat and could only be accomplished because of the collective leadership and collaborative working across all partners within NHS Wales Performance and Improvement and the health boards and trusts in Wales.”
Introduction of the scores is an important milestone for patient safety in Wales, providing a platform for further work to be undertaken to improve the identification of acute deterioration and the response to it.
NHSWPI will now be offering a range of support to teams throughout NHS Wales, which will include help for strengthening the reliability of escalation systems through the Safe Care Partnership, and assisting with the implementation of a Patient and Family Initiated Escalation system named Call 4 Concern across Wales
Dominique Bird, Interim National Director for Quality, Safety and Improvement, NHS Wales Performance and Improvement, said: “The introduction of standardised Early Warning Scores is a key development for patient safety in Wales. Introducing the scores for all age groups within a short timeframe is a notable achievement by our health boards and trusts, which deserves recognition.
“NHS Wales Performance and Improvement will continue offering support to teams to embed these tools into practice, towards achieving the safest possible care across Wales.”