Parents’ Concerns to Trigger Urgent Reviews for Children in A&E

A new national warning system is being introduced in hospital emergency departments across England to help healthcare professionals identify children whose conditions may be deteriorating.

Under the National Paediatric Early Warning System, known as PEWS, concerns raised by parents, carers, children or healthcare professionals can trigger an immediate escalation of a child’s care.

How Will The New Warning System Work?

The system is designed to:

• – Provide a consistent approach to recording and assessing children’s vital signs;
• – Monitor measures including blood pressure, heart rate and oxygen levels;
• – Apply assessment criteria appropriate to the child’s age;
• – Help staff identify when more urgent clinical attention may be required; and
• – Allow concerns raised by a parent, carer, child or healthcare professional to prompt an escalation of care.

More than 90 hospitals in England are already using the national PEWS system on paediatric inpatient wards. The programme is now being introduced in emergency departments.

Parents and carers know their children well and may recognise when their condition has changed. Under the system, concerns raised by a parent, carer or the child can trigger an immediate escalation of care, even if the clinical score remains low.

Listening To Parents’ And Carers’ Concerns

The development reflects the principle behind Martha’s Rule, which recognises that people close to a patient may notice early signs of deterioration. It gives patients, families and carers a route to request a rapid review when they are concerned that a patient’s condition is worsening, and they feel their concerns are not being addressed.

Michelle Gyte, Medical Negligence Solicitor at Howells Solicitors, said:

“Parents and carers will often recognise when a child’s condition or behaviour has changed, even where the initial clinical observations may not provide a complete picture.”

“A consistent national system that brings together clinical observations and concerns raised by families should help staff identify deterioration earlier and respond more quickly.”

“The effectiveness of the system will ultimately depend on staff having the time, training and resources to record observations properly, respond to warning scores and listen when families say that something is not right.”

What Should Parents And Carers Do If They Are Concerned?

Parents and carers should tell the treating team immediately if they believe a child’s condition is getting worse. It may help to explain the specific change they have noticed, when it began and how the child’s condition or behaviour differs from normal.

If their concerns are not being addressed, they can ask:

• – When were the child’s observations last completed?
• – Has the child’s PEWS score changed?
• – Can the child be reviewed by a senior clinician?
• – Is there an escalation process, including Martha’s Rule, available at the hospital?

Martha’s Rule is not yet available in every healthcare setting.

How Can Howells Solicitors Help?

Where a child has suffered serious harm following a delay in recognising or responding to deterioration, their family may understandably have questions about the care provided.

Our medical negligence team can help families understand what happened, access relevant medical records and consider whether further investigation is required.