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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 information and support on NEWS2

Additional NEWS2 resources:


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

RESTORE2 was co-produced by West Hampshire Clinical Commissioning Group (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 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 the Frimley Health and Care Integrated Care System in 2019.

Berkshire West care home support delivers online training and implementation support for RESTORE2.

Oxford Health Care Home Support Service started a pilot RESTORE2 training programme in early 2021. The Oxford Patient Safety Collaborative worked with this team to run online RESTORE2 training sessions for over 300 care home staff in 2022/23.


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 consider 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). Read more about ReSPECT here


[1] Situation, Background, Assessment, Recommendation, Decision. This helps to provide a structure for an interaction that helps both the giver and receiver of information. It helps the giver by ensuring they have formulated their thinking before trying to communicate it to someone else. Further information in this document (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