What is the NEWS2 Score?
The National Early Warning Score 2 (NEWS2) is a standardised tool used across the UK NHS to assess and respond to acute illness in adult patients. It aggregates six physiological measurements plus a flag for supplemental oxygen into a single score that signals clinical deterioration. This calculator follows the Royal College of Physicians 2017 NEWS2 specification and is intended for adults (16+), not for pregnancy or children.
How to use it
Enter the patient's respiration rate, oxygen saturation (choosing SpO2 Scale 1 for most patients or Scale 2 for those at risk of hypercapnic respiratory failure), whether they are on supplemental oxygen, systolic blood pressure, heart rate, temperature, and level of consciousness on the ACVPU scale. The tool returns the total NEWS2 score plus each sub-score and a clinical risk band.
The formula
Score = Σ(sub-scores) for the seven parameters. Each measurement falls into a band worth 0–3 points. Being on oxygen adds 2 points. A confused, voice-, pain- or unresponsive patient scores 3 for consciousness. The total ranges 0–20.
$$\text{NEWS2} = S_{RR} + S_{SpO_2} + S_{O_2} + S_{SBP} + S_{HR} + S_{Temp} + S_{ACVPU}$$where
$$\left\{ \begin{aligned} S_{RR} &= f(\text{Resp. rate}) \\ S_{SpO_2} &= f(\text{SpO}_2,\ \text{Scale},\ \text{O}_2) \\ S_{O_2} &= \begin{cases} 2 & \text{on oxygen} \\ 0 & \text{air} \end{cases} \\ S_{SBP} &= f(\text{Systolic BP}) \\ S_{HR} &= f(\text{Heart rate}) \\ S_{Temp} &= f(\text{Temp}) \\ S_{ACVPU} &= \begin{cases} 3 & \text{not Alert} \\ 0 & \text{Alert} \end{cases} \end{aligned} \right.$$
Worked example
A patient on oxygen, RR 28 (3), SpO2 90% on Scale 1 (3), oxygen yes (2), SBP 88 (3), HR 35 (3), temp 34.5°C (3), new confusion (3) gives \(3+3+2+3+3+3+3 = 20\) — the maximum score and an urgent High-risk alert.
FAQ
What is the maximum score? 20 points.
What does a high score mean? A total of 7 or more is High risk and triggers an emergency clinical response; 5–6 is Medium; 0–4 is Low. A single parameter scoring 3 warrants urgent review even at a low total.
Should I use Scale 1 or Scale 2? Scale 2 is only for patients with confirmed hypercapnic respiratory failure (e.g. some COPD) where a target range of 88–92% applies; everyone else uses Scale 1.
