New NHS system will help doctors spot seriously ill children faster in A&E

The NHS is introducing a new early warning system across emergency departments in England to help doctors and nurses identify when children are becoming seriously ill and ensure they receive urgent treatment as quickly as possible

The National Paediatric Early Warning System (NPEWS) will be rolled out in emergency departments from winter 2026. It aims to improve patient safety by giving healthcare staff a consistent way to monitor children’s health and recognise signs of deterioration.

More than six million children attend emergency departments in England every year, with most experiencing mild or short-term illnesses. However, identifying those who are seriously unwell and need immediate attention is vital.

How will the new system work?

NPEWS involves medical staff regularly checking and recording a child’s vital signs, including blood pressure, heart rate, breathing rate and oxygen levels.

These measurements are used to calculate an overall score, with higher scores indicating that a child may need more urgent medical attention.
NPEWS also recognises that a numerical score does not always tell the full story. Parents, carers and children will be encouraged to raise concerns if they notice a change in the child’s condition.

Any concerns raised by families, children or medical staff will trigger an immediate escalation of care, even if the child’s clinical score is low.

The system also includes separate charts for different age groups, ensuring that assessments reflect the normal vital signs and specific healthcare needs of babies, children and young people.

Building on an existing NHS initiative

The NPEWS system is already being used in the paediatric inpatient wards of more than 90 hospitals across England.

Data from these hospitals have shown consistently lower rates of cardiac arrests among patients, highlighting the potential benefits of recognising deterioration earlier.

The expansion into emergency departments is expected to make England’s rollout the world’s largest standardised paediatric early warning scoring system.

NHS England developed the programme in collaboration with the Royal College of Paediatrics and Child Health and the Royal College of Nursing, with input from clinical teams.

Part of wider plans to improve children’s care

The introduction of NPEWS forms part of wider NHS efforts to improve children’s healthcare and prepare hospitals for winter pressures.

It follows the recent expansion of Martha’s Rule to emergency departments and waiting rooms, allowing patients, families and staff to request an urgent review if they worry a patient’s condition is worsening and their concerns are not being addressed.

The NHS is also developing new standards for children’s treatment in A&E, with plans to make eliminating corridor care for young patients a priority.

Supporting guidance, training and educational resources will be provided to help emergency department teams introduce the system effectively.
The overall aim is to ensure seriously ill children are recognised sooner, concerns are taken seriously, and treatment is provided without unnecessary delays.