WIlliam Harrison

1. Steps should be taken to highlight to junior medical and nursing staff the need to escalate the assessment of patients who have a National Early Warning Score (“NEWS”) in excess of 7 in terms of the NEWS checklist. 2. Consideration should be given to revising the guidance on significant adverse events to further emphasise the importance of establishing the facts of what happened, resolving any conflicts of evidence. 3. Steps should be taken to remind staff who will be responsible for medically expected patients that they should consider what is said in the GP referral. 4. Nursing and medical staff should be reminded to sign or initial notes to identify the author and to time an entry at the time the patient was seen. 5. Medical staff should be reminded of the manner in which drugs for immediate administration should be recorded on the once only prescription form and instructions issued to that effect. A copy of this determination should be sent to Health Protection Scotland in order that they may consider whether it has wider application.