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A preimplementation survey for a standardised approach to paediatric early warning systems
  1. Jayne Wheway1,
  2. Philippa Anna Stilwell2,
  3. Adam Cook3,
  4. Damian Roland4,5
  1. 1Patient Safety Team, NHS England and NHS Improvement, London, UK
  2. 2Children and Young People's Transformation Team, NHS England and NHS Improvement, London, UK
  3. 3Patient Safety Measurement Unit, NHS England and NHS Improvement, London, UK
  4. 4SAPPHIRE Group, Health Sciences, University of Leicester, Leicester, UK
  5. 5Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, University of Leicester, Leicester, UK
  1. Correspondence to Dr Damian Roland, Health Sciences, University of Leicester, Leicester LE1 7RH, UK; dr98{at}

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The term paediatric early warning systems (PEWS) has emerged to describe an array of interventions needed to improve recognition of children who require review/escalation of care. In 2005, 21.5% of National Health Service (NHS) trusts in the UK that care for children used a PEWS1; by 2013, 85% of units were using a PEWS and 18% had an RRT (Rapid Response Teams) in place.2 The PEWS in use were extremely variable: 36 different parameters were used in various combinations in 2005, growing to 47 in 2013.

In 2018, NHS England and NHS Improvement (NHSE/I), the Royal College of Paediatrics and Child Health and the Royal College of Nursing brought together a national PEWS Programme Board with the aim of producing a national PEWS for England. This letter describes the …

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  • Twitter @damian_roland

  • Contributors The original idea was conceived by DR and JW. JW and PAS wrote initial drafts and completed data collection. AC provided data analysis support.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests JW, AS and DR are members of the National PEWS steering committee.

  • Patient consent for publication Not required.

  • Ethics approval The authors reviewed the National Institute for Health Research advice on defining research (available from: and determined that this project was not classified as research.

  • Provenance and peer review Not commissioned; externally peer reviewed.