In response to NHS reforms within critical care, the surgical directorate of the Southern Derbyshire Acute Hospitals NHS Trust developed and introduced a modified early warning system (DMEWS). Anecdotal evidence from nursing staff indicated that response times by doctors, when triggered by use of the DMEWS, were outside the established timescale. An audit was undertaken to determine the response times to calls for assistance triggered by use of the DMEWS and to identify any disparity between response times. The audit confirmed that whilst DMEWS triggered the nurses to initiate action for immediate treatment, response by members of the surgical teams was below the agreed standards. Further studies are planned to indicate whether longer response times have an adverse effect on patient welfare or outcome.