NHS England is introducing a new early warning system in emergency departments across England to help spot signs of deterioration in children's health. The National Paediatric Early Warning System (Pews) will be used by doctors and nurses to measure, record and assess vital signs, marking the first time such technology has been available in A&E.
How the system works
The system assesses blood pressure, heart rate, breathing rates, oxygen levels and consciousness. A high score indicates when a child may require more urgent attention. Pews is being introduced in emergency departments from this winter, and NHS England said the mass roll-out will make it the largest standardised scoring system in the world.
NHS bosses said Pews is not designed to replace professional judgment or the input of parents, carers and children into a child's condition. Concerns raised can still trigger an immediate escalation of care, even if a child's Pews score is low.
Support from health leaders
Duncan Burton, chief nursing officer for England, said: "In fast-paced emergency departments, staff need to spot quickly when a child's condition is deteriorating."
"This standardised approach will help them recognise the warning signs, communicate concerns, and make timely decisions when every moment matters. Just as importantly, it makes sure the concerns of children, parents and carers are heard and can prompt action."
The new Pews will also include age-appropriate charts to reflect what may be abnormal signs of deterioration in babies, children and young people. It has been designed specifically for A&E to help with rapid decision-making in busy environments.
Rollout and impact
Dr Mike McKean, vice-president for policy at the Royal College of Paediatrics and Child Health (RCPCH), which worked on the new Pews system, said: "I am delighted to see this initiative being rolled out ahead of the winter period, which is always a busy and challenging time for hospitals and healthcare professionals."
Professor Lynn Woolsey, from the Royal College of Nursing, which was also involved in the work, said: "Early escalation is critical for keeping patients safe, particularly children. Already saving lives in other parts of the NHS, this system is a vital tool for nursing staff to quickly identify when a child patient is deteriorating, and act."
More than 90 hospitals across England use the national inpatient Pews system, and data suggests they are seeing consistently lower rates of cardiac arrests among their patients, NHS England said. A similar system, the National Early Warning System, is in place for adults and is already used by NHS hospitals. Separately, NHS England is drawing up urgent new standards for how children should be treated in A&E, including eliminating corridor care for youngsters as a priority.
