Recurring concern
Unreliable clinical Early Warning Score systems for deterioration
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Request correctionFirst reported 24 Sep 2013•Latest report 5 Feb 2026
What this concern includes
Includes failures to obtain, record or repeat required EWS observations; calculate scores accurately; make charts and scores accessible; define monitoring intervals; and initiate review or escalation required by EWS or NEWS thresholds.
Not included
- Excludes physiological monitoring that is not part of an Early Warning Score system.
- Excludes failures after a score has been correctly calculated, made available and escalated according to the applicable EWS protocol.
- Excludes fetal CTG, condition-specific monitoring and non-clinical scoring tools.
- Reports
- 67
- Individual concerns
- 94
- Date range
- 2013–2026
- Stated actions
- 138
Distinct published reports
A report can raise multiple concerns
First to latest report issue date
Described in published responses
Reports over time
Reports over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Concerns and responses across reports
Only concerns grouped under this recurring concern are included. Select any concern, action or position to view the source wording.
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Concerns raised1
Failure to accurately score MEWS tools on medical charts
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.5
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Action
Provide extensive staff training on accurate MEWS and fluid-balance recording and recognition and response to patient deterioration, including sepsis.
Stated by Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust -
Action
Continue monthly deterioration, MEWS and fluid-balance training for staff involved in patient care.
Stated by Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust -
Action
Deliver the QUEST programme to train nursing staff in MEWS use and accurate scoring.
Stated by Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust
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Action
Conduct monthly audits of nursing compliance with MEWS standards and feed results back to ward and nursing managers.
Stated by Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust -
Action
Operate a monthly Task and Finish Group to oversee MEWS use, audit findings, compliance and scoring accuracy.
Stated by Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust
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Concerns raised2
Failure to act on early warning scores
Miscalculation of early warning scores
This report raised 12 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
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Action
Provide Critical Care outreach support and follow-up when elevated early warning scores are identified.
Stated by The Trust -
Action
Deliver the Trust-wide project and improvement measures to improve accurate acute monitoring using early warning scores.
Stated by The Trust -
Action
Pilot the revised Maternity Early Warning Scoring Chart and make necessary alterations before embedding it in practice.
Stated by The Trust
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Action
Introduce a newborn observation chart based on the British Association of Paediatric Medicine Newborn Early Warning Score.
Stated by The Trust
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Concerns raised2
Failure of nursing staff to accurately score vital signs in the NEWS system
Failure of nursing staff to recognise and implement recommended NEWS escalation measures
This report raised 9 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Failure to use the modified obstetric early warning score tool appropriately to identify sepsis
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
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Concerns raised1
Failure to complete National Early Warning System scoring after acute deterioration
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.2
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Position
NEWS scores were not expected during the medical emergency because the early warning system had already fulfilled its function.
Stated by University Hospitals Sussex NHS Foundation Trust
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Position
No remedial action was considered necessary because the medical records contained appropriate detail about AMU care and NEWS scores.
Stated by University Hospitals Sussex NHS Foundation Trust
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Concerns raised2
Failure to record NEWS scores on drug charts
Failure to escalate NEWS scores to doctors
This report raised 23 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
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Action
Monitor documentation more closely and provide nurses with real-time feedback.
Stated by University Hospitals Sussex NHS Foundation Trust -
Action
Review and condense Acute Medical Unit documentation into multidisciplinary paperwork that directs care and reduces duplication.
Stated by University Hospitals Sussex NHS Foundation Trust -
Action
Assign a critical care outreach nurse to link the Acute Medical Unit with critical care services.
Stated by University Hospitals Sussex NHS Foundation Trust
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Concerns raised1
Failure to progress a pre-hospital validated early warning score system
This report raised 14 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
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Action
Review the possibility of introducing a pre-hospital early warning score system in London.
Stated by London Ambulance Service NHS Trust -
Action
Raise a national pre-hospital early warning system with JRCALC and request its inclusion in the scheduled workstream agenda.
Stated by College of Paramedics -
Action
Participate in national working groups or committees developing and establishing an early warning system compatible with receiving health facilities.
Stated by College of Paramedics
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Concerns raised3
Failure to reliably record and communicate the Early Warning Score across healthcare staff
Unclear interim arrangements for where the Early Warning Score is recorded
Unavailability of the iHospital system for improving Early Warning Score recording
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.3
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Action
Embed ward safety briefings and provide education to improve multidisciplinary communication of EWS.
Stated by Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust -
Action
Embed a status-at-a-glance board showing EWS scores and due observation times on ATC.
Stated by Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust -
Action
Implement the i-Hospital system to identify high EWS patients, due observations and discharge EWS assessment opportunities.
Stated by Doncaster and Bassetlaw Teaching Hospitals NHS Foundation Trust
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Concerns raised1
Failure to accurately calculate and use patient observation scores
This report raised 7 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
Actions described in response An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.1
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Action
Replace PARS with NEWS, train Trust staff in NEWS scoring, provide an escalation guide and maintain refresher training as needed.
Stated by Tameside and Glossop Integrated Care NHS Foundation Trust
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Concerns raised1
Difficulty entering Paediatric Early Warning Scoring information into GP medical records
This report raised 4 other concerns. They are not shown here because they do not form part of this recurring concern.
Responses linked to these concernsEach statement is shown once, even when linked to more than one concern.
No linked response statementsNo respondent-stated action or position is linked to these concerns in the published data.
Data last updated 7 September 2026