What is a NEWS2 score?

NEWS2 is the National Early Warning Score 2, a standardised system from the UK Royal College of Physicians that aggregates seven physiological parameters into a single score. It is used across the NHS to detect and respond to clinical deterioration in acutely ill adults.

What NEWS2 score triggers escalation?

A total of 0 to 4 is low risk, 5 to 6 (or any single parameter scoring 3) is medium risk requiring urgent review, and 7 or more is high risk needing an emergency clinical response. A single red score of 3 in one parameter mandates urgent review even if the total is low.

When should SpO2 Scale 2 be used?

Scale 2 is used only for patients with a prescribed oxygen saturation target of 88 to 92 percent, typically those with hypercapnic (type 2) respiratory failure such as some COPD patients. The scoring thresholds differ markedly from Scale 1, so the correct scale must be confirmed by a clinician.

Does supplemental oxygen affect the score?

Yes. A patient breathing room air scores 0 for the oxygen parameter, while any supplemental oxygen adds 2 points. This reflects the increased clinical concern when a patient needs oxygen support to maintain their saturations.

Is this calculator a substitute for clinical judgement?

No. NEWS2 is a screening and escalation aid, not a diagnosis. It must be interpreted alongside the full clinical picture, local protocols, and senior review. Always follow your organisation's escalation policy.

NEWS2 Score Calculator

What the NEWS2 score measures

The National Early Warning Score 2 (NEWS2) is the standardised tool used throughout the NHS to identify acutely ill adults who are deteriorating. Published by the Royal College of Physicians, it converts seven routinely measured vital signs into points (0 to 3 each), producing an aggregate score that drives a defined monitoring and escalation response. The goal is to catch deterioration early, before a patient arrests or requires intensive care.

How it works

Each parameter is mapped to a point value using the official RCP weighting tables:

Respiratory rate (breaths/min): scores 3 if ≤8, 1 if 9–11, 0 if 12–20, 2 if 21–24, 3 if ≥25.
Oxygen saturation uses two scales. Scale 1 (default): 3 if ≤91, 2 if 92–93, 1 if 94–95, 0 if ≥96. Scale 2 (target 88–92% on oxygen): scores differently and gives extra points when saturations rise on oxygen.
Air or oxygen: room air scores 0; any supplemental oxygen scores 2.
Systolic blood pressure (mmHg): 3 if ≤90, 2 if 91–100, 1 if 101–110, 0 if 111–219, 3 if ≥220.
Pulse (beats/min): 3 if ≤40, 1 if 41–50, 0 if 51–90, 1 if 91–110, 2 if 111–130, 3 if ≥131.
Consciousness: Alert scores 0; any new Confusion, Voice, Pain, or Unresponsive (the C of ACVPU and below) scores 3.
Temperature (°C): 3 if ≤35.0, 1 if 35.1–36.0, 0 if 36.1–38.0, 1 if 38.1–39.0, 2 if ≥39.1.

The points are summed. A total of 0–4 is low risk, 5–6 (or any single parameter scoring 3) is medium risk, and 7 or more is high risk. The single-parameter “red score” rule is important: even a low total triggers urgent review if any one observation scores 3.

Tips and worked example

A patient with respiratory rate 22 (2), SpO2 95% on Scale 1 (1), on supplemental oxygen (2), systolic BP 105 (1), pulse 115 (2), Alert (0), and temperature 38.4°C (1) scores a total of 9 — high risk, requiring an emergency clinical response with continuous monitoring.

Always confirm the correct SpO2 scale before scoring: applying Scale 1 thresholds to a Scale 2 patient (or vice versa) can substantially change the result. NEWS2 supports but does not replace clinical judgement and your local escalation protocol.