Parents' worries will now trigger urgent checks for children in A&E under new early warning system

A new early warning system is being introduced in hospital emergency departments across England to help staff spot children whose condition is getting dangerously worse, and for the first time, a parent's worry will be enough to trigger urgent action.

The National Paediatric Early Warning System, known as PEWS, asks staff to check, record and score a child's vital signs, such as blood pressure, heart rate and oxygen levels. A high overall score means the child needs attention more urgently. Crucially, concerns raised by staff, parents, carers or the child themselves will trigger an immediate escalation of care.

The NHS says the system is designed to save lives ahead of winter, when pressure on emergency departments is at its highest.

Built on what already works

The approach is already proven on children's wards. More than 90 hospitals in England have been using the alert system there, with age-appropriate assessments for babies right through to teenagers. A similar early warning system for adults, which helps identify acutely ill patients including those with sepsis, is already used in emergency departments and general wards.

Bringing it into emergency departments means children will be assessed in the same consistent way from the moment they arrive.

"When every moment matters"

Duncan Burton, chief nursing officer for England, called it an "important next step in improving care for children and young people across England for this winter - and beyond".

"In fast-paced emergency departments, staff need to spot quickly when a child's condition is deteriorating," he said. "This standardised approach will help them recognise the warning signs, communicate concerns, and make timely decisions when every moment matters."

PEWS has been developed by NHS England together with the Royal College of Paediatrics and Child Health and the Royal College of Nursing.

Martha's Rule in every A&E

The change sits alongside the expansion of Martha's Rule to all hospital emergency departments in England. The rule gives patients, families and carers the right to ask for a rapid review if they are worried a patient is getting worse and their concerns are not being heard. A&E units will have a dedicated phone number to call to trigger an urgent review.

The rule is named after Martha Mills, who died aged 13 in 2021 after developing sepsis in hospital following a bike accident. A coroner found her family's concerns were not listened to and that she would probably have survived had she been moved to intensive care sooner. Her parents, Merope and Paul, came up with the idea to change the culture that contributed to her death.

The Health Secretary, Yvette Cooper, has also promised to end "corridor care" for sick children. "No child should be treated in a corridor. No patient should be treated in a corridor," she said recently.

What it means for Birmingham families

For parents in Birmingham, where children's emergency care includes the dedicated emergency department at Birmingham Children's Hospital, the message is simple: if you think your child is getting worse, say so. Under the new system, that concern counts, and staff are expected to act on it straight away.