Maternal and Neonatal Deterioration - elearning for healthcare
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About the content

NHS England is approaching how to manage deterioration in a consistent way. This has involved the development and introduction of a framework called PIER which focuses on prevention, identification, escalation and response to ensure early recognition and management of deterioration.

The new national Maternity Early Warning Score (MEWS) tool has been developed with key stakeholders to replace the range of different MEWS tools that are currently available and sits within the PIER framework. The MEWS tool has been designed to ensure that identification of deterioration is based on pure physiology using a total score. This total score is combined with subjective assessments (additional concerns) which support the escalation process.

The new Newborn Early Warning Track and Trigger (NEWTT2) tool also sits within the PIER framework and replaces the NEWTT framework designed by the British Association of Perinatal Medicine (BAPM) in 2015. BAPM have updated the tool to reflect quality improvement methodology and feedback from healthcare professionals.

NHS England have developed 2 elearning sessions to support the introduction and implementation of the 2 new tools:

1. Introduction to the Maternity Early Warning Score
This session introduces the new national Maternity Early Warning Score (MEWS) tool and describes why and how the tool was developed. The learning outcomes are:

  • describe how MEWS links to the PIER framework
  • explain how to complete a MEWS tool
  • explain the difference of postnatal pulse and the significance on the MEWS tool
  • describe how the presence of additional concerns supports escalation
  • describe the graduated thresholds and triggers table

2. Deterioration of the newborn NEWTT2
This session introduces the new Newborn Early Warning Track and Trigger (NEWTT2) tool. The learning outcomes are:

  • explain the link between NEWTT2 and PIER framework
  • describe how to complete a NEWTT2 tool
  • explain the inclusion of normothermia and critical observations
  • explain the graduated thresholds and triggers table

More information

A recurring theme in national reports into maternity care has highlighted a combination of failures in the management of deterioration. These include failure to recognise signs of deterioration and failure to escalate concerns and respond to them.

Due to normal physiological changes of pregnancy, the National Early Warning Score (NEWS) is not directly transferrable to the pregnant population.

There is a wide variation in the range of MEWS tools currently in use. This includes variation in the included physiological parameters, cut offs for alerting, escalation, and variation in clinical areas within which a MEWS tool is used.

The national MEWS tool has been developed with key stakeholders and designed with insights from population data and consensus building with healthcare professionals.

Primary and secondary audiences

All healthcare professionals engaged in hospital based perinatal care.

Clinical team

  • Tony Kelly

    Consultant Obstetrician. National Clinical Adviser, Maternity and Neonatal Safety Improvement Programme
  • Hannah Rutter

    RM. Senior Improvement Manager, Maternity and Neonatal Safety Improvement Programme
  • Amanda Andrews

    RM. Programme Manager, Innovation Agency AHSN
  • Tracey Sargent

    RM. Programme Manager – Children, Young People and Maternity, Southwest AHSN
  • Tendai Nzirawa

    FRCN, RN, RSCN. Maternity Clinical Improvement Lead, Eastern AHSN

elfh team members

  • Sarah Gray

    Sarah Gray

    Programme Manager, NHSE eLearning for healthcare
  • Essi Niittymaki

    Project Manager, NHSE eLearning for healthcare
  • Karen Walker - ID

    Karen Walker

    Lead Learning Designer, NHSE eLearning for healthcare
  • Ian Blacklock

    Ian Blacklock

    Learning Designer, NHSE eLearning for healthcare
  • Abigail Lingford

    Abigail Lingford

    Graphic Designer, NHSE eLearning for healthcare
  • Louise Garrahan

    Louise Garrahan

    Senior Marketing and Communications Officer, NHSE eLearning for healthcare

How to access

Available to all

The new Maternal and Neonatal Deterioration course is freely available to access here.
Please note your progress and completion of sessions will not be recorded and you will not be able to generate a record of completion. If you require evidence of learning, please register and then log in to access this programme on the elfh Hub.

If you already have an account with elfh, then you can enrol on to the Maternal and Neonatal Deterioration course by logging in to the elfh Hub, selecting My Account > Enrolment and selecting the Recognising and managing deterioration programme. You can then access the programme immediately in the My eLearning section.

Register >

To view the Maternal and Neonatal Deterioration course, select the View button below. If you already have an account with elfh, you will also be able to login and enrol on the programme from the View button.

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Registering large numbers of users

If you are a HR, IT or Practice Manager and would like to register and enrol large numbers of staff within your organisation for access onto the News and Deterioration programme, please contact elfh directly.

Organisations wishing to use their own LMS

For HR departments wanting to know more about gaining access to courses using an existing Learning Management System please contact elfh directly to express interest.

More information

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