NHS England is rolling out the national paediatric early warning system in A&E departments across England for the first time this winter. The warning system uses a scoring process to help staff judge whether a child needs more urgent attention, including in the busiest emergency departments.
Duncan Burton said: “In fast-paced emergency departments, staff need to spot quickly when a child’s condition is deteriorating.” He added: “This standardised approach will help them recognise the warning signs, communicate concerns, and make timely decisions when every moment matters.”
Duncan Burton and Pews charts
The system is already used for inpatients, but this winter it is being introduced in A&E for the first time. It uses Pews charts for babies, children and young people, and checks blood pressure, heart rate, breathing rates, oxygen levels and consciousness. A high score can flag when a child is deteriorating, while concerns raised by children, parents and carers can still trigger immediate escalation even if the score is low.
Mike McKean 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.” He added: “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.”
England for the NHS
More than 6 million children attend A&E in England each year, and NHS England is using the rollout alongside training and resources for staff. The same scoring approach already exists for adults through the national early warning system in NHS hospitals, but this version is designed specifically for A&E to support rapid decisions in busy settings.
Lynn Woolsey said: “Early escalation is critical for keeping patients safe, particularly children.” NHS England is also drawing up urgent new standards for how children should be treated in A&E, including making the elimination of corridor care for youngsters a priority.
For families, the practical point is simple: staff now have a shared tool for judging deterioration, but Pews does not replace clinical judgment or the concerns of children, parents and carers. Those concerns can still prompt immediate action, even when the score does not.
