England's National Health Service is introducing a new early warning system in hospital emergency departments to help staff quickly identify children whose condition is deteriorating rapidly.
The National Paediatric Early Warning System (PEWS) requires staff to check, log and grade vital signs including blood pressure, heart rate and oxygen levels. A high score flags a child for more urgent attention. Concerns raised by staff, parents, carers or the child trigger immediate escalation of care.
The system comes after Health Secretary Yvette Cooper pledged to end "corridor care" for sick children. The initiative was prompted in part by the case of two-year-old Finlay Roberts, who died in 2024 after spending hours waiting in a hospital corridor at Whittington Health NHS Trust before being discharged. Cooper apologised to Finlay's parents, saying "No child should be treated in a corridor."
More than 90 hospitals across England have already used the alert system in children's wards, with age-appropriate assessments for infants through teenagers. A similar early warning system for adults is already in use in NHS emergency and general wards.
The rollout also accompanies an expansion of Martha's Rule to all hospital emergency departments in England. The rule allows patients, families and carers to request a rapid review if they believe a patient's condition is worsening and their concerns are not being addressed. A&E units will have a dedicated phone number to trigger urgent reviews. The rule was named after Martha Mills, who died aged 13 in 2021 after developing sepsis in hospital. A coroner ruled her family's concerns about her worsening condition were not heeded and she would likely have survived with earlier intensive care.
Duncan Burton, chief nursing officer for England, called the early warning system an "important next step" for improving care during winter months when NHS pressure peaks. The system is a collaboration between NHS England, the Royal College of Paediatrics and Child Health and the Royal College of Nursing.