Paediatric Early Warning Score

A key ambition of the Managing Deterioration Safety Improvement Programme (ManDetSIP) is to support the spread and adoption of the acute Paediatric Early Warning Score (PEWS) and a system-wide paediatric observations tracker for children across all appropriate care settings in England by March 2024.

PEWS can effectively recognise and respond to an acutely deteriorating child or young person. While almost all hospitals use a form of PEWS, currently there is no single nationally-validated system in England.  A standardised PEWS tool used in every inpatient setting could help eliminate variation and remove the challenge for clinical staff as they move between sites using different observation charts, scoring systems and escalation processes.

NHS England & Improvement have been working with Royal College of Paediatrics and Child Health (RCPCH) and Royal College of Nursing (RCN) to standardise the charts across all NHS systems. System-Wide Paediatric Observations Tracking (SPOT) is designed to monitor deterioration in children for a range of conditions on hospital wards.

The initial focus is on developing a system that works in inpatient settings. It is intended to adapt and expand the PEWS system into emergency departments (EDs), the community, ambulances and primary care. The chart will be available in both paper and digital formats, so Trusts can use either depending on what systems they already have in place.

Over 30 sites chosen to begin a pilot of this new chart with four acute sites in the South West: Torbay Hospital, Royal Cornwall Hospital, Musgrove Park Hospital and Royal Devon and Exeter Hospital. Working with the West of England AHSN, who are supporting two sites in their region – Bath and Gloucester – we will help to identify challenges and overcome any obstacles.

For more information about the programme, please contact