Your web browser is outdated and may be insecure

The RCN recommends using an updated browser such as Microsoft Edge or Google Chrome


RCN instrumental in new warning system for spotting deterioration in children and young people

The patient safety tool was developed by NHS England, in partnership with the RCN, after calls for a standardised system to detect signs of clinical deterioration such as sepsis.

Child being monitored in hospital setting

Today (3 November), NHS England has launched an early warning system for health care staff treating children and young people to quickly identify deterioration and escalate care. The RCN has been calling for a standardised warning system for children and young people in the NHS for some time.

Working in partnership with the RCN and the Royal College of Paediatric and Child Health, NHS England has been developing the Paediatric Early Warning System (PEWS) for more than three years with pilots running across 15 sites.

PEWS allows health care staff to track possible deterioration in a child’s condition on a chart, measuring things like blood pressure, heart rate, oxygen levels and levels of consciousness, with different scores representing the level of concern.

Although many hospitals already have systems in place, this change will provide a single, national standardised process for patients, families and staff to have a clear way of ensuring issues are detected and escalated quickly.

NHS England is rolling out a leaflet and video content for parents, letting them know how to communicate concerns to health care staff and encouraging them to escalate their concerns if needed.

RCN Head of Nursing Practice Wendy Preston said: “Parents must be able to raise the alarm if their child is becoming seriously unwell. In the past children have needlessly, and tragically died. Nursing is a safety-critical profession, and we have been calling for a standardised warning system in the NHS to try and stop such tragic cases from ever happening again.

 “To help save patients’ lives, the RCN children and young people forums have played a key role in the development of this new warning system which will improve care for children and young people.

“We now need to see this warning system implemented successfully across the NHS. For it to be effective, there must be investment in the nursing workforce including training and education of staff so they can use the new warning system to act swiftly when a patient’s condition deteriorates.”

There is a similar system in place for adults, the National Early Warning System, and now children and young people will benefit from a standardised approach in a hospital setting. There are also plans to expand this into mental health, ambulance and community services. There are similar systems in other countries within the UK, too.

Keep an eye out for our new webpage on recognising and managing deteriorating patients, which will be live soon. It will provide useful resources for a variety of settings, including adult, mental health, maternity, children and young people, and learning disability.