NHS England is introducing a new early warning system in emergency departments across the country to help detect seriously ill children more quickly. This system, known as the National Paediatric Early Warning System (Pews), has previously been used for inpatients but marks its first implementation in emergency settings.
The Pews system allows doctors and nurses to measure and record vital signs, including blood pressure, heart rate, breathing rates, oxygen levels, and consciousness. A high score generated by the system signals when a child's condition may be worsening and requires more immediate attention.
NHS England stated that this rollout will establish Pews as the world's largest standardized scoring system of its kind. It is scheduled to be implemented in emergency departments starting this winter. The system is designed to complement, not replace, the clinical judgment of healthcare professionals or the input from parents, carers, and children themselves. Concerns raised by these individuals can still prompt an immediate escalation of care, regardless of a child's Pews score.
Duncan Burton, chief nursing officer for England, emphasized the system's role in fast-paced emergency departments. "This standardized approach will help them recognise the warning signs, communicate concerns, and make timely decisions when every moment matters," he said. "Just as importantly, it makes sure the concerns of children, parents and carers are heard and can prompt action."
The new Pews incorporates age-specific charts to account for variations in vital signs that might indicate deterioration in babies, children, and young people. It has been specifically adapted for A&E environments to aid rapid decision-making.
More than six million children attend A&E departments in England annually. A similar system, the National Early Warning System, is already in use for adults in NHS hospitals.
Separately, NHS England is developing new standards for pediatric A&E care, with a priority to eliminate corridor care for young patients. Health secretary Yvette Cooper affirmed the commitment to children's health, stating, "All of us want the reassurance of knowing that if a child is seriously ill, it will be spotted in time by the NHS and that's exactly what this new early warning system... is designed to do."
Dr. Mike McKean, vice-president for policy at the Royal College of Paediatrics and Child Health, which contributed to the system's development, expressed enthusiasm for its introduction before the winter period. "The launch of the emergency department Pews charts are extremely important tools that will support all paediatricians and wider child health teams to spot deterioration in children in hospital," he noted.
Professor Lynn Woolsey from the Royal College of Nursing highlighted the critical role of early escalation in patient safety, particularly for 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," she stated. She also stressed the importance of adequate staffing, capacity, training, and support for the system's effective use, emphasizing the need to listen to children, young people, parents, and carers.