Timelines and responsibilities for Early Warning Scores (EWS) (WHC/2025/002)

Status:

Action.

Category:

Quality and safety.

Title:

Timelines and responsibilities for the implementation of Early Warning Scores (EWS) to identify acute deterioration.

Date of expiry / review:

Non-applicable.

Action by:

Local health boards, NHS trusts and primary care providers.

Required by:

September 30, 2025.

Sender:

Professor Pushpinder Mangat, Deputy Chief Medical Officer, Health Services.
Professor Sue Tranka, Chief Nursing Officer, Nurse Director NHS Wales.

Welsh Government contacts:

Tom Warren,
Quality and Safety,
Quality and Nursing Directorate.
Tel: 03000 258109.
Email: QualityAndNursing@gov.wales

Enclosures:

None.

The Welsh Health Circular (WHC) ‘Standardising the management of acute deterioration’ (WHC/2024/035) set out our expectation in relation to standardising the management of acute deterioration in local health boards, NHS trusts and primary care providers.

This WHC identifies the timelines and organisational responsibilities for implementing 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).

Implementation timelines

To reduce variation and therefore improve patient safety, all NHS Wales organisations are expected to adhere to the following implementation deadlines:

• NEWS2: Implementation in all areas where NEWS or NEWS Cymru is currently used by 30 September 2025.
• PEWS: Full implementation in all acute paediatric services by 30 September 2025.
• NEWTT2: The Maternity and Neonatal Network have set out the expectation that NEWTT2 will have commenced by 31st March 2025 and will be fully implemented in acute settings by 30th September 2025.
• MEWS: The Maternity and Neonatal Network have set out the expectation that MEWS will have commenced by 31st March 2025 and will be fully implemented in acute settings by 30th September 2025.

NHS Wales responsibilities

As noted in WHC/2024/035, organisations will not be required to fund any new posts for the implementation of the recommended EWS although it is expected they will allow teams the time to work with the NHS Executive and the Acute Physical Deterioration Implementation Network (APDI Network) to ensure improvements and adoption of the standardised tools identified above.

The APDI Network will be working collaboratively with health boards, trusts, Critical Care, Trauma and Emergency Care Networks, Child Health Network, Maternity and Neonatal Network and the NHS Wales Executive Quality, Safety and Improvement Directorate to implement Early Warning Scores across all ages and develop systems to improve response and escalation for staff, patients, and families.

To ensure this work is successful we ask that an executive sponsor and implementation lead (eg Health Board Recognition of Acute Deterioration and Response (RADAR) / resuscitation group lead) be identified for each health board and trust. The expectation is that these individuals will be the point of contact for the APDI Network and will have responsibility and accountability for this work.

Please forward names and contact details to the Acute Deterioration Implementation Network Manager Christopher.hancock2@wales.nhs.uk no later than 31st March 2025. It is anticipated that the first meeting of the responsible and accountable officers will take place in May 2025.

We would like to thank you for your continued hard work and commitment to this essential initiative which will improve quality, safety and outcomes for the people of Wales.

Yours sincerely,

Professor Push Mangat.

Professor Sue Tranka.