Kathleen Allen

“The Mews Chart contained within Mrs [name redacted] A and E records was the Heart of England NHS Foundation Trust 'Adult MEWS Observation Chart'. The Escalation Pathway was clearly set out providing that for a MEWs of between 1 and 3 there should be consideration of increasing frequency of observations and”

“The evidence of the staff nurse caring for Mrs [name redacted] during the evening of the 18 March was that he did not alert the Nurse in Charge when Mrs [name redacted] MEWS went up to three (having gradually risen from 0 at the time of arrival) because A and E nurses had been told that this part of the escalation pathway did not apply in A and E”

“It therefore appears that there is not a consistent approach to MEWS SOP in Birmingham Heartlands ED: members of staff are being told different things and there appears to be a different procedure in operation to that set out in documents within patient records. There is a risk that staff within ED will not be taking a consistent, evidence based approach to MEWS and also that non ED based clinicians, reviewing patients in ED will not be aware of the difference in MEWS procedure operating in ED”