A parent’s concern that their child’s condition is worsening should trigger an immediate escalation of care in emergency departments under the PEWS system being introduced in England, according to the BBC. The approach combines scores based on vital signs with a response to concerns raised by families, staff or children themselves.
The National Paediatric Early Warning System (PEWS) is designed to help identify dangerous deterioration in children’s health. In an article published on 2 November, the BBC reports that it is being introduced in England’s accident and emergency (A&E) departments. That does not mean the rollout has been completed at every hospital.
Vital signs and families’ concerns both count
The system involves checking, recording and scoring a child’s vital signs, including blood pressure, heart rate and oxygen levels. A high combined score indicates a need for more urgent help. Scoring is tailored to different age groups.
Responding to concerns is another important part of the approach. According to the BBC’s description, concerns raised by a parent, carer, healthcare professional or the child themselves should trigger an immediate escalation of care — urgently alerting staff to the potential danger and prompting an appropriate response. Families’ observations therefore matter alongside the measurements.
The BBC reports that more than 90 hospitals in England were already using the warning system on children’s wards. The rollout now being reported concerns A&E departments. No detailed timetable was given for its introduction at individual hospitals.
PEWS is a joint initiative involving NHS England, the Royal College of Paediatrics and Child Health and the Royal College of Nursing, the professional bodies for paediatricians and nursing staff. England’s chief nursing officer, Duncan Burton, quoted by the BBC, said that a standardised approach would help staff quickly recognise signs of deterioration, communicate concerns and make decisions.
PEWS and Martha’s Rule are separate mechanisms
The BBC also reports an announced extension of Martha’s Rule to all emergency departments in England. This allows patients, families and carers to request a rapid review if they are worried that a patient’s condition is worsening and their concerns are not being addressed.
Martha’s Rule is not another name for PEWS. PEWS helps identify deterioration in a child’s condition and trigger a staff response, while Martha’s Rule provides a way to request a further assessment when concerns have gone unanswered. Both aim to secure a faster response when a patient’s health is at risk. The changes described apply to England, not the whole of the UK.
