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NEWS2 and RESTORE2

NEWS2

NEWS2 is the latest version of the National Early Warning Score (NEWS) from the Royal College of Physicians (RCP), first produced in 2012 and updated in December 2017, which advocates a system to standardise the assessment and response to acute illness. NEWS2 provides a common language across healthcare and aims to reduce variation and improve the quality of care. This supports the aims of the NHS Patient Safety Strategy.

NHS England FAQs for NEWS2 implementation

Additional NEWS2 resources:

RESTORE2

RESTORE2 is a physical deterioration and escalation tool specifically designed for care homes based. It uses the same NEWS2 scoring system, but also incorporates early recognition (from ‘Soft Signs’) and a structured communications tool (SBARD[1]). Download the RESTORE2 Observation Chart here.

RESTORE2 was co-produced by West Hampshire CCG[2] and Wessex Patient Safety Collaborative.  It is designed to support homes and health professionals to:

  • Recognise when a resident may be deteriorating or at risk of physical deterioration
  • Act appropriately according to the resident’s care plan to protect and manage the resident
  • Obtain a complete set of physical observations to inform escalation and conversations with health professionals
  • Speak with the most appropriate health professional in a timely way to get the right support
  • Provide a concise escalation history to health professionals to support their professional decision making.

RESTORE2 Mini

RESTORE2 mini is a shortened version of RESTORE2 and may be better suited for non-registered care staff, carers and paid support staff who are not expected to perform observations.  It covers “soft signs” of deterioration and structured communication. Download the RESTORE2 Mini Observation Chart here.

Regional projects

Following a pilot in three care homes, launched in January 2020, RESTORE2 was rolled out to all care homes in Buckinghamshire. This was introduced in collaboration with Buckinghamshire Healthcare NHS Trust and Buckinghamshire CCG[3]. Read the pilot project case study and watch a video from one of the care homes here. Training is now provided free of charge to all care homes in Bucks by Immedicare.

RESTORE2 was rolled out by Frimley Integrated Care System in 2019.

Berkshire West care home support delivers online training and implementation support for RETSORE2 supporting training.

Oxford Health Care Home Support Service started a pilot RESTORE2 training programme in early 2021. Oxford Patient Safety Collaborative (part of Oxford AHSN), will now be working in collaboration with this team, by running online RESTORE2 training sessions.

Resources

Our online training courses online training courses are free of charge. They are open to any carers working in care homes in Berkshire, Buckinghamshire , Milton Keynes and Oxfordshire.

There any many RESTORE2 Resources to help with local training and rollout. These include these short videos describing how to take vital signs measurements from residents (e.g. blood pressure and oxygen saturation), and how to spot the signs of deterioration and prevent the spread of infection.

Most information can be found in this RESTORE2 Rollout Handbook.

Recommended Summary Plan for Emergency Care and Treatment (ReSPECT)

 We recommend that care homes also considering using Advance Care Plans for their residents.  ReSPECT is a process that creates personalised recommendations for a person’s immediate clinical care, in a future emergency in which they cannot make or express choice.  It can be used alongside RESTORE2 (or independently of it).

ReSPECT was devised by the Resuscitation Council UK.  More information and can be found on their website here.

They have also provided information specific to care homes.

Links to other information relating to ReSPECT can also be found on our webpage.

[1] Situation, Background, Assessment, Recommendation, Decision.  This helps to provide a structure for an interaction that helps both the giver of the information and the receiver of it. It helps the giver by ensuring they have formulated their thinking before trying to communicate it to someone else https://www.england.nhs.uk/wp-content/uploads/2021/03/qsir-sbar-communication-tool.pdf (some versions do not include the ‘D’ for decision)

[2] Now part of the Hampshire and Isle of Wight Integrated Care System

[3] Now part of Buckinghamshire, Oxfordshire and Berkshire West Integrated Care System.