A&E warning system to flag sick children deteriorating quickly
The initiative, in England, will help busy staff identify children who are deteriorating quickly as they wait for emergency care.
A new early warning system, the National Paediatric Early Warning System (PEWS), is being rolled out in NHS hospital emergency departments across England. The system aims to help staff quickly identify children who are rapidly deteriorating in their condition. By checking, logging and grading vital signs such as blood pressure, heart rate and oxygen levels, staff can flag a high overall score indicating urgent attention is needed.
If concerns are raised by staff, parents, carers or the child themselves, it triggers immediate escalation of care. The initiative comes in response to long waits for hospital beds and aims to prevent children from being treated in hospital corridors, as seen in the tragic case of two-year-old Finlay Roberts who died last year after spending hours in a corridor before discharge.
Whittington Health NHS Trust extended condolences to Finlay's family, stating they still experience periods of exceptional demand in emergency care. A similar early warning system for acutely ill adults is already in use in NHS hospital wards. Over 90 hospitals in England have been using the alert system in children's wards, with age-appropriate assessments for babies to teenagers.
The NHS has pledged to expand Martha's Rule, which grants patients, families and carers the right to request a rapid review if they suspect a patient's condition is worsening and their concerns are not being addressed. Named after Martha Mills, who died in 2021 from sepsis following a bike accident, the rule aims to change hospital culture and improve care for children in emergency departments.
Duncan Burton, chief nursing officer for England, emphasized the importance of the new PEWS system in improving care for children and young people across England for the upcoming winter and beyond. Burton added that the standardized approach will help staff quickly recognize warning signs, communicate concerns and make timely decisions when every moment matters. The PEWS system is a collaboration between NHS England, the Royal College of Paediatrics and Child Health, and the Royal College of Nursing.
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