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England to use PEWS scoring in A&E to flag deteriorating children
The BBC reports NHS England is introducing the National Paediatric Early Warning System in hospital emergency departments to score children's vital signs and escalate care, including when families raise concern.
NHS England is introducing the National Paediatric Early Warning System, or PEWS, in hospital emergency departments in England so staff can log and grade children's vital signs and flag those whose condition is worsening while they wait, the BBC reported1.
The BBC said the tool asks staff to check blood pressure, heart rate and oxygen levels, among other measures, with a high overall score meaning a child needs more urgent attention1. Concerns from staff, parents, carers or the child themselves will trigger an immediate escalation of care, according to that report1.
A similar early-warning system for acutely ill adults, including those with sepsis, is already used on emergency and general NHS wards, the BBC said, and more than 90 hospitals in England have used the paediatric version on children's wards, with age-appropriate assessments from babies to teenagers1.
The BBC tied the A&E rollout to winter pressure and to comments by Health Secretary Yvette Cooper after the 2024 death of two-year-old Finlay Roberts, who the BBC said spent hours in a hospital corridor before being discharged1. Cooper apologized to his parents on the BBC's Sunday with Laura Kuenssberg, saying no child should be treated in a corridor1. Whittington Health NHS Trust, where Finlay waited, extended condolences and said it still sees periods of exceptional demand in which some patients may be treated in temporary clinical areas, including corridors, the BBC reported1.
The same piece said the NHS will expand Martha's Rule to all hospital emergency departments in England, giving patients, families and carers a right to request a rapid review if they think a patient's condition is worsening and their concerns are not being answered1. The rule is named after Martha Mills, who died at 13 in 2021 after sepsis following a bike accident; a coroner ruled her family's concerns were not listened to and that she would probably have survived had she been moved to intensive care earlier, the BBC reported1. A&E units will have a dedicated phone number to trigger an urgent review, according to that account1.
Duncan Burton, chief nursing officer for England, called the children's A&E warning system "an important next step in improving care for children and young people," the BBC reported1. PEWS is a collaboration between NHS England, the Royal College of Paediatrics and Child Health and the Royal College of Nursing, according to the BBC1.
The BBC report does not give a start date beyond winter, does not quantify expected lives saved, and does not describe independent evaluation of the A&E expansion. Not medical advice.