Chart 1: The NEWS scoring system

Physiological Score
parameter 3 2 1 0 1 2 3

Respiration rate
≤8 9–11 12–20 21–24 ≥25
(per minute)

SpO2 Scale 1 (%) ≤91 92–93 94–95 ≥96

88–92 93–94 on 95–96 on ≥97 on

SpO2 Scale 2 (%) ≤83 84–85 86–87
≥93 on air oxygen oxygen oxygen

Air or oxygen? Oxygen Air

Systolic blood
≤90 91–100 101–110 111–219 ≥220
pressure (mmHg)

Pulse (per minute) ≤40 41–50 51–90 91–110 111–130 ≥131

Consciousness Alert CVPU

Temperature (°C) ≤35.0 35.1–36.0 36.1–38.0 38.1–39.0 ≥39.1

National Early Warning Score (NEWS) 2 © Royal College of Physicians 2017

Chart 2: NEWS thresholds and triggers

NEW score Clinical risk Response

Aggregate score 0–4 Low Ward-based response

Red score Low–medium Urgent ward-based response*
Score of 3 in any individual parameter
Aggregate score 5–6 Medium Key threshold for urgent response*

Aggregate score 7 or more High Urgent or emergency response**

* Response by a clinician or team with competence in the assessment and treatment of acutely ill patients and in recognising when the
escalation of care to a critical care team is appropriate.
**The response team must also include staff with critical care skills, including airway management.

National Early Warning Score (NEWS) 2 © Royal College of Physicians 2017

 NEWS key FULL NAME
0 1 2 3 DATE OF BIRTH DATE OF ADMISSION

DATE DATE
TIME TIME

3
A+B
≥25 ≥25
21–24 2 21–24
Respirations 18–20 18–20
Breaths/min 15–17 15–17
12–14 12–14
9–11 1 9–11
≤8 3 ≤8

AB
≥96 ≥96
+ 94–95 1 94–95
SpO2 Scale 1 92–93 2 92–93
Oxygen saturation (%) ≤91 3 ≤91

SpO2 Scale 2† ≥97 on O2 3 ≥97 on O2

Oxygen saturation (%) 95–96 on O2 2 95–96 on O2
Use Scale 2 if target
range is 88–92%,
93–94 on O2 1 93–94 on O2
eg in hypercapnic ≥93 on air ≥93 on air
respiratory failure
88–92 88–92
86–87 1 86–87

ONLY use Scale 2 under the

†
84–85 2 84–85
direction of a qualified clinician ≤83% 3 ≤83%

Air or oxygen? A=Air A=Air

O2 L/min 2 O2 L/min
Device Device

≥220 3 ≥220

C
Blood
201–219
181–200
201–219
181–200
pressure 161–180 161–180
mmHg
141–160 141–160
Score uses
systolic BP only 121–140 121–140
111–120 111–120
101–110 1 101–110
91–100 2 91–100
81–90 81–90
71–80 71–80
61–70 3 61–70
51–60 51–60
≤50 ≤50

≥131 3 ≥131

C
Pulse
121–130
111–120
2
121–130
111–120
Beats/min 101–110 101–110
91–100
1 91–100
81–90 81–90
71–80 71–80
61–70 61–70
51–60 51–60
41–50 1 41–50
31–40 31–40
≤30
3 ≤30

Alert Alert

D
Consciousness
Confusion
V
Confusion
V
Score for NEW onset of P 3 P
confusion (no score if chronic)
U U

≥39.1° 2
E
≥39.1°
38.1–39.0° 1 38.1–39.0°
Temperature 37.1–38.0° 37.1–38.0°
°C 36.1–37.0° 36.1–37.0°
35.1–36.0° 1 35.1–36.0°
≤35.0° 3 ≤35.0°

NEWS TOTAL TOTAL

Monitoring frequency Monitoring

Escalation of care Y/N Escalation
Initials Initials

National Early Warning Score 2 (NEWS2) © Royal College of Physicians December 2022
Chart 4: Clinical response to the NEWS trigger thresholds

NEW score Frequency of monitoring Clinical response

0 Minimum 12 hourly • Continue routine NEWS monitoring

• Inform registered nurse, who must

assess the patient
Total
Minimum 4–6 hourly • Registered nurse decides whether increased
1–4
frequency of monitoring and/or escalation of
care is required

• Registered nurse to inform medical team

3 in single parameter Minimum 1 hourly caring for the patient, who will review and
decide whether escalation of care is necessary

• Registered nurse to immediately inform the

medical team caring for the patient
Total
• Registered nurse to request urgent assessment
5 or more
Minimum 1 hourly by a clinician or team with core competencies
Urgent response
in the care of acutely ill patients
threshold
• Provide clinical care in an environment with
monitoring facilities

• Registered nurse to immediately inform the

medical team caring for the patient – this
should be at least at specialist registrar level
Total • Emergency assessment by a team with critical
7 or more Continuous monitoring of care competencies, including practitioner(s)
Emergency response vital signs with advanced airway management skills
threshold • Consider transfer of care to a level 2 or 3
clinical care facility, ie higher-dependency unit
or ICU
• Clinical care in an environment with
monitoring facilities

National Early Warning Score (NEWS) 2 © Royal College of Physicians 2017