NHS England has launched the National Paediatric Early Warning System (Pews) across A&E departments in England for winter 2026, marking the world's largest rollout of a standardized pediatric scoring tool. Designed alongside expert clinical bodies, the system measures vital signs to catch rapid health deterioration in the more than six million children visiting emergency rooms annually. Crucially, parental concerns will automatically trigger immediate clinical care escalations regardless of numerical scores. The initiative accompanies strict new NHS standards aimed at ending corridor treatment for pediatric patients following notable fatal care failures, including the deaths of Martha Mills and two-year-old Finlay Roberts.
Rollout and impact of PEWS in hospitals
- ▪NHS England announced the winter 2026 rollout of the National Paediatric Early Warning System (Pews) across A&E departments in England, expanding the scoring tool from inpatient wards to emergency care.
- ▪The mass rollout of the National Paediatric Early Warning System in NHS emergency departments makes it the largest standardised scoring system in the world.
- ▪More than 90 hospitals across England already use the inpatient National Paediatric Early Warning System, showing consistently lower rates of cardiac arrests among child patients.
How the Paediatric Early Warning System works
- ▪The National Paediatric Early Warning System is designed to allow concerns raised by staff, parents, carers, or children to trigger an immediate escalation of care even if the calculated Pews score is low.
- ▪The National Paediatric Early Warning System utilizes age-appropriate charts to identify abnormal signs of health deterioration across babies, children, and young people.
- ▪A high score under the National Paediatric Early Warning System flags that a child patient requires urgent medical attention in emergency departments.
- ▪The National Paediatric Early Warning System requires medical staff to measure, record, and score vital signs including blood pressure, heart rate, breathing rate, oxygen levels, and consciousness.
Expansion and background of Martha's Rule
- ▪Martha's Rule was established following the 2021 death of 13-year-old Martha Mills from sepsis after hospital staff failed to respond to her family's concerns regarding her worsening condition.
- ▪NHS England planned the expansion of Martha's Rule to all hospital emergency departments in England, establishing dedicated phone numbers for families to request urgent care reviews.
Finlay Roberts case and trust response
- ▪Two-year-old Finlay Roberts died in 2024 after spending hours waiting in a hospital corridor at Whittington Health NHS Trust before being discharged without basic observations.
- ▪Health Secretary Yvette Cooper issued an apology on behalf of the NHS to the parents of Finlay Roberts, stating that no child or patient should be treated in a corridor.
- ▪Whittington Health NHS Trust stated that periods of exceptional emergency care demand force some hospital patients to receive care in temporary clinical areas such as corridors.
Government and NHS focus on paediatric care
- ▪Health Secretary Yvette Cooper stated that children's health needs to become a much greater focus for the entire National Health Service.
- ▪NHS England is drawing up new urgent standards for pediatric care in A&E departments, prioritizing the complete elimination of corridor care for children.
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