NHS England to deploy pediatric scoring tool in A&E this winter

NHS England will introduce a new scoring tool in emergency departments across the country this winter. The pediatric early warning system (Pews) uses vital signs to determine if a child requires more urgent care. While hospitals have used the tool for inpatients for some time, this rollout marks its first use in A&E settings. This expansion makes Pews the largest standardized scoring system for children in the world.

Medical staff will use the system to measure blood pressure, heart rate, breathing rates, oxygen levels, and consciousness. A high score flags potential deterioration to doctors and nurses. NHS England stated that the tool is designed to support professional judgment rather than replace it. Parents and carers can still raise concerns that trigger immediate escalation of care, even if a child’s score is low.

The system includes age-appropriate charts to identify abnormal signs in babies, children, and young people. The design accounts for the rapid decision-making required in busy emergency rooms. More than six million children attend A&E in England each year. A similar tool for adults, the national early warning system, is already standard in NHS hospitals.

Duncan Burton, the chief nursing officer for England, said the approach helps staff recognize warning signs quickly. "In fast-paced emergency departments, staff need to spot quickly when a child’s condition is deteriorating," Burton said. He added that the system ensures concerns from children and parents are heard and can prompt action.

Dr. Mike McKean, vice-president for policy at the Royal College of Paediatrics and Child Health, welcomed the rollout ahead of the winter period. He noted that the charts are important tools for spotting deterioration. The college worked on the development of the new Pews system.

Prof. Lynn Woolsey of the Royal College of Nursing emphasized that early escalation is critical for patient safety. She noted that the system supports consistent assessment and communication across emergency departments and pediatric wards. Both colleges were involved in the work to develop the tool.

NHS England reported that more than 90 hospitals currently use the inpatient version of Pews. Data from these facilities suggests consistently lower rates of cardiac arrests among their patients. Separately, NHS England is drafting new standards for child treatment in A&E, including a priority to eliminate corridor care.