The NHS is rolling out an early warning system in emergency departments in England to help doctors and nurses spot children whose condition is deteriorating and treat them faster.

NHS England announced on 2 November that the National Paediatric Early Warning System (PEWS) will reach emergency departments from this winter. Staff will measure, record and assess a child's vital signs — blood pressure, heart rate, breathing rate and oxygen levels — and combine them into an overall score, with higher scores triggering more urgent attention.

Parents and carers will also be asked about changes in their child's condition, and any concern raised by staff, parents or the child will trigger immediate escalation of care, even if the clinical score is low. Separate age-appropriate charts cover babies, children and young people, reflecting their different normal ranges.

The rollout builds on the introduction of PEWS in children's inpatient wards in November 2023. More than 90 hospitals already use it on their wards, and NHS England says those trusts have consistently lower cardiac arrest rates among their patients. The expansion is expected to make it the largest standardised scoring system for children's health in the world.

England's chief nursing officer, Duncan Burton, said the approach would help staff "recognise the warning signs, communicate concerns, and make timely decisions when every moment matters". Health Secretary Yvette Cooper said children's health needed to be "a much greater focus for the whole NHS".

The rollout is part of NHS winter preparations, when emergency departments face their heaviest pressure. More than six million children attend emergency departments in England each year. It follows the extension of Martha's Rule to all hospital emergency departments a month earlier, and the NHS is also drawing up new standards for children in A&E, including plans to end corridor care for children.