England: The NHS is introducing a national paediatric early warning system (Pews) across emergency departments (A&E) in England this winter to help doctors and nurses identify children whose health is deteriorating and ensure they receive timely medical attention.
The initiative will make Pews the world’s largest standardised early warning scoring system. The tool is already used in hospital wards for children admitted as inpatients, but its expansion will mark the first time it is implemented across emergency departments in England.
Pews uses a scoring system based on a child’s vital signs, including blood pressure, heart rate, breathing rate, oxygen levels and consciousness. Medical teams can use these measurements to assess a child’s condition and identify signs that require urgent intervention.
A higher score alerts healthcare professionals to possible deterioration, helping them decide when additional medical attention is needed. However, the system is not intended to replace clinical judgment or concerns raised by children, parents and carers. Medical teams can escalate care immediately if concerns arise, even when a child’s Pews score is low.
Duncan Burton, Chief Nursing Officer for England, stated that the emergency department staff needed effective ways to recognise signs of deterioration quickly in fast-moving clinical environments.
Burton remarked that the standardised approach would help healthcare professionals identify warning signs, communicate concerns and make timely decisions. The Chief also emphasised that the concerns of children, parents and carers must be heard and acted upon.
The system includes age-specific charts designed to identify abnormal vital signs in babies, children and young people. It has also been adapted for emergency departments to support faster assessments and decisions in busy hospital settings.
More than 6 million children visit A&E departments in England every year. The NHS already operates a similar early warning system for adult patients, known as the National Early Warning Score.
Separately, NHS England is developing new urgent standards for children’s treatment in emergency departments, with ending corridor care for young patients identified as a priority.
Dr. Mike McKean, Vice-President for Policy at the Royal College of Paediatrics and Child Health (RCPCH), which contributed to developing Pews, welcomed the rollout ahead of the winter period, when hospitals typically face increased pressure.
McKean added that the emergency department charts would help paediatricians and wider child health teams identify signs of deterioration and improve patient safety and quality of care. The VP also highlighted the importance of providing healthcare teams with appropriate training and resources.
Prof Lynn Woolsey of the Royal College of Nursing, which also contributed to the initiative, said early escalation was essential to keeping children safe.
Woolsey noted that the early warning system was already helping save lives in other parts of the NHS and would give nursing staff an important tool to recognise when a child’s condition was worsening.
The Professor also stressed the need for sufficient nursing staff, capacity, training and support to ensure the system could be used effectively across emergency departments and paediatric wards.
ALSO READ | Bolivia declares state of emergency over El Niño threat
