National Early Warning Score (NEWS)

Important

NEWS is an adult early-warning score. It is designed to standardise assessment of acute illness and identify physiological deterioration. It is not a diagnostic test for sepsis and should not replace clinical judgement.

Do not use NEWS for children or neonates. Use an age-appropriate pediatric/neonatal early-warning system.

Patient observations

Respiratory rate

breaths/minute

Oxygen saturation (SpO₂)

% on current oxygen/air

Systolic blood pressure

mmHg

Pulse

beats/minute

Temperature

°C

Level of consciousness

NEWS uses ACVPU. New confusion scores 3.

Oxygen therapy

Breathing room air Receiving supplemental oxygen

SpO₂ scoring scale

Scale 2 should only be selected when clinically indicated. It is primarily intended for patients with hypercapnic respiratory failure who have a prescribed target saturation of 88–92%, commonly in COPD. In all other circumstances use Scale 1.

NEWS result

Total NEWS

0

Enter all observations

Complete the observation set to calculate NEWS.

  0–4: Lower score
  5–6: Urgent response threshold
  Single parameter = 3: urgent attention
  ≥7: Emergency response threshold

NEWS scoring ranges

Physiological parameter	3 points	2 points	1 point	0 points	1 point	2 points	3 points
Respiratory rate breaths/min	≤8		9–11	12–20	21–24		≥25
SpO₂ Scale 1 %	≤91	92–93	94–95	≥96
SpO₂ Scale 2 %	≤83	84–85	86–87	88–92	93–94	95–96	≥97
Supplemental oxygen		Yes		Air
Systolic BP mmHg	≤90	91–100	101–110	111–219			≥220
Pulse beats/min	≤40		41–50	51–90	91–110	111–130	≥131
Consciousness	ACVPU			Alert			Confusion/C/V/P/U
Temperature °C	≤35.0		35.1–36.0	36.1–38.0	38.1–39.0		≥39.1

NEWS response thresholds

NEWS finding	Suggested response
0–4	Continue routine NEWS monitoring according to local policy.
Single parameter score of 3	Urgent clinical assessment should be considered because a single markedly abnormal physiological parameter may indicate significant deterioration.
Total 5–6	Urgent clinical response / assessment. Increase monitoring and investigate the cause of deterioration according to local escalation policy.
Total ≥7	Emergency response threshold. Immediate assessment and consideration of higher-level care are required according to local policy.

Clinical safety: A NEWS score should never override obvious clinical concern. If the patient appears critically ill, escalate immediately regardless of the calculated score.

References

Royal College of Physicians. National Early Warning Score (NEWS) 2: Standardising the assessment of acute-illness severity in the NHS. London: RCP; 2017.
Official RCP NEWS report
Royal College of Physicians. Chart 1: The NEWS scoring system.
Official NEWS scoring chart
Royal College of Physicians. NEWS: Additional implementation guidance. 2021.
RCP implementation guidance
Royal College of Physicians. NHS England approves use of NEWS. 2018.
RCP NEWS information

This calculator reproduces the NEWS scoring ranges published by the Royal College of Physicians. It is intended for educational and clinical decision-support use and should be implemented alongside your institution's NEWS escalation and monitoring policy.