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NHS launches new warning system to spot seriously ill children faster in A&E

NHS launches new warning system to spot seriously ill children faster in A&E

A new NHS alert system aims to spot seriously ill children faster in A&E, with parents' concerns playing a crucial role.

Ruairidh Pritchard

Published: November 2, 2026 at 7:26 AM

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When your child is seriously unwell, every minute matters. Now, the NHS is rolling out the world's largest early warning system for sick children across A&E departments in England, designed to spot when a child's condition is getting dangerously worse before it's too late.

The National Paediatric Early Warning System (PEWS) will help doctors and nurses identify seriously ill babies, children and teenagers who need urgent attention. And there's an important change for parents too: your concerns could trigger an immediate review of your child's care, even if their medical observations appear reassuring.

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The rollout comes ahead of the busy winter period, when NHS emergency departments face increased pressure. With more than six million children attending A&E in England every year, the new system aims to make emergency care safer and more consistent across the country.

How does the new NHS warning system work?

The new system uses a standardised scoring system to help healthcare professionals recognise early signs that a child's health is deteriorating.

Doctors and nurses will measure, record and assess vital signs, including:

Heart rate: How quickly your child's heart is beating
Breathing rate: Whether they're breathing faster or slower than expected
Oxygen levels: How much oxygen is circulating in their blood
Blood pressure: An important indicator of how well their body is functioning
Consciousness: How alert and responsive your child is

These measurements are combined into an overall score, helping staff identify children who may need urgent assessment or treatment.

The system includes age-appropriate charts for babies, children and teenagers, recognising that normal vital signs change as children grow.

More than 90 hospitals in England already use PEWS on children's wards, but this winter marks the first time the national system will be introduced across A&E departments.

According to NHS England, data suggests hospitals already using the inpatient system have consistently lower rates of cardiac arrests among patients.

Why parents' concerns could make a crucial difference

Perhaps the most reassuring part of the new system is that medical scores won't be the only factor determining whether a child needs urgent attention.

NHS England has confirmed that concerns raised by parents, carers, children or healthcare professionals can trigger an immediate escalation of care, even when a child's PEWS score is low.

That means if you feel something isn't right with your child, your observations should be taken into account alongside their medical assessments.

Duncan Burton, chief nursing officer for England, said the system would help medical teams recognise warning signs and make faster decisions in busy emergency departments.

Just as importantly, it makes sure the concerns of children, parents and carers are heard and can prompt action.

Duncan Burton, chief nursing officer for England

What is Martha's Rule and how does it help parents?

The rollout comes alongside plans to expand Martha's Rule to all hospital emergency departments in England.

The rule is named after 13-year-old Martha Mills, who died from sepsis in 2021 after her family's concerns about her deteriorating condition were not acted upon.

It gives patients and families the right to request a rapid review if they're worried someone's condition is worsening and feel their concerns aren't being addressed.

A&E departments will have a dedicated phone number that families can call to request an urgent review of care.

Why is the NHS making these changes now?

The announcement follows growing concerns about overcrowding and delays in children's emergency care.

Health Secretary Yvette Cooper recently apologised to the parents of two-year-old Finlay Roberts, who died in 2024 after spending hours in a crowded hospital corridor before being discharged.

The NHS is also developing new standards for children's emergency care, with eliminating corridor care for young patients identified as a priority.

The Royal College of Paediatrics and Child Health and the Royal College of Nursing helped develop the new warning system.

Professor Lynn Woolsey, from the Royal College of Nursing, welcomed the rollout but stressed that hospitals would need sufficient staffing, training and support to use it effectively.

What should parents do if their child gets worse in A&E?

If you're waiting in A&E and notice your child's condition changing, it's important to tell a healthcare professional straight away.

Speak up immediately: Tell a nurse or doctor if your child develops new symptoms or seems to be getting worse.
Explain what's unusual: If your child is much sleepier, less responsive or behaving differently from normal, make sure staff know.
Ask for reassessment: If you're concerned about deterioration, ask for your child to be checked again.
Ask about Martha's Rule: If your concerns aren't being addressed, find out how to request an urgent review.

The new system won't remove A&E waiting times or replace doctors' clinical judgement, but it aims to help staff recognise seriously ill children sooner.

And for parents, the message is particularly important: you know your child, and your concerns deserve to be heard.

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Authors

Ruairidh PritchardDigital Growth Lead

Ruairidh is the Digital Lead on MadeForMums. He works with a team of fantastically talented content creators and subject-matter experts on MadeForMums.