NEWS2 Scale 1 spreadsheet exercise: scoring bands and single-parameter triggers

Educational arithmetic with fictional observations

This independent spreadsheet exercise is not an official RCP observation chart or a clinically validated decision-support tool. NEWS2 supports clinical judgement; it does not diagnose sepsis, mandate ICU admission or establish that a patient is safe. Use official charts and local clinical procedures in patient care.

The worked example uses oxygen saturation Scale 1 only. It is not suitable for a person who needs Scale 2, which requires clinical selection for confirmed hypercapnic respiratory failure; a COPD label alone is not enough. NEWS2 is not intended for children under 16 or pregnant patients.

The inputs represent six physiological measurements plus a two-point supplement for oxygen. Use whole-number respiratory rate, saturation percentage, systolic pressure and pulse, and temperature in Celsius to one decimal place. Missing inputs and unknown text labels are rejected rather than treated as normal.

New confusion is distinct from a pre-existing baseline condition. The allowed consciousness labels are Alert, New confusion, Voice, Pain and Unresponsive. Oxygen is entered as Yes or No. This validation is a worksheet input contract, not a complete plausibility or clinical assessment.

Aggregate points for the Scale 1 example

D2:D8 show individual contributions; C2 contains the total and C3 the largest contribution. Any invalid input prevents a total. The worksheet has no oxygen Scale 2 calculation.

=IF(OR(COUNT(B2:B3,B5:B6,B8)<>5,AND(B4<>"Yes",B4<>"No"),AND(B7<>"Alert",B7<>"New confusion",B7<>"Voice",B7<>"Pain",B7<>"Unresponsive")),"Invalid inputs",IF(OR(B2<0,B3<0,B3>100,B5<=0,B6<0,B8<=-273.15,B2<>INT(B2),B3<>INT(B3),B5<>INT(B5),B6<>INT(B6),ABS(B8*10-ROUND(B8*10,0))>0.00000001),"Invalid inputs",IFS(B2<=8,3,B2<=11,1,B2<=20,0,B2<=24,2,TRUE,3)+IFS(B3<=91,3,B3<=93,2,B3<=95,1,TRUE,0)+IF(B4="Yes",2,0)+IFS(B5<=90,3,B5<=100,2,B5<=110,1,B5<=219,0,TRUE,3)+IFS(B6<=40,3,B6<=50,1,B6<=90,0,B6<=110,1,B6<=130,2,TRUE,3)+IF(B7="Alert",0,3)+IFS(B8<=35,3,B8<=36,1,B8<=38,0,B8<=39,1,TRUE,2)))

Threshold category including the single red score

A total of 7 or more takes precedence, followed by 5–6. Below 5, any single contribution of 3 is the separate red-score category, not the ordinary 0–4 category. These labels describe the scoring example, not a diagnosis or a patient-specific treatment instruction. Even a zero score does not override clinical concern.

=IF(OR(NOT(ISNUMBER(C2)),NOT(ISNUMBER(C3))),"Invalid inputs",IFS(C2>=7,"High: aggregate 7+",C2>=5,"Medium: aggregate 5-6",C3=3,"Low-medium: single red score",TRUE,"Low: aggregate 0-4, no red score"))

Further reading

• Microsoft Support — IFS function
• Royal College of Physicians — NEWS2 report and official charts
• RCP — Official scoring system (Chart 1)
• RCP — Official thresholds and triggers (Chart 2)