England's NHS is introducing a new early warning system in hospital emergency departments to identify deteriorating children more quickly, following deaths linked to delayed care.
The National Paediatric Early Warning System (PEWS) asks staff to check and grade vital signs including blood pressure, heart rate and oxygen levels. A high score triggers more urgent attention. Concerns raised by staff, parents, carers or the child themselves will trigger immediate escalation of care.
The system rolls out ahead of winter, when NHS pressure peaks. More than 90 hospitals across England have already used PEWS in children's wards with age-appropriate assessments for babies through teenagers.
The initiative follows the death of two-year-old Finlay Roberts in 2024. A coroner raised concerns that busy staff failed to perform basic observations while Finlay spent hours in a crowded hospital corridor before being discharged. Health Secretary Yvette Cooper apologised to his parents, saying "No child should be treated in a corridor. No patient should be treated in a corridor."
Whittington Health NHS Trust, where Finlay was treated, said it continued to experience periods of exceptional demand and at times some patients receive care in temporary clinical areas, including corridors.
The rollout also follows Martha's Rule, which gives patients, families and carers the right to request a rapid review if they worry a patient's condition is worsening and concerns are not being addressed. A&E units will have a dedicated phone number to trigger urgent care reviews. The rule is named after Martha Mills, who died aged 13 in 2021 from sepsis after her family's concerns about her worsening condition were not heeded by hospital staff.
Duncan Burton, chief nursing officer for England, called PEWS an "important next step" for helping staff "spot quickly when a child's condition is deteriorating" in fast-paced emergency departments.