NHS Rolls Out New Early Warning System for Children in A&E

Pews previously reduced cardiac arrest rates on inpatient wards.

This winter marks the first time A&E departments will use Pews. These departments handle over six million child attendances annually.

Duncan Burton, a leading figure in the rollout, stated, "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."

The mass rollout across England will make Pews the largest standardised scoring system of its kind globally. NHS England states the system does not replace professional judgment or the input of parents, carers, and children into a child’s condition.

Lynn Woolsey emphasized the importance of early intervention. She stated, "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."

Concerns raised by parents or carers can still trigger immediate escalation of care, regardless of a child's Pews score. This aligns with the expansion of Martha's Rule to all hospital emergency departments in England, allowing patients, families, and carers to request a rapid review if worried about a patient's condition.

A coroner previously ruled that Martha Mills' family's concerns were not listened to. She likely would have survived if moved to intensive care earlier. This case highlights the importance of ensuring that the concerns of children, parents, and carers are heard and can prompt action, a point Burton also stressed.

Dr. Mike McKean welcomed the initiative. He stated, "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." He added that 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.

NHS England draws up urgent new standards for how children should be treated in A&E. These include eliminating corridor care for youngsters as a priority. Woolsey also stressed the importance of ensuring enough nursing staff, with adequate capacity, training, and support, to effectively use the system and spot deterioration.