Response
Noted
The response acknowledges concerns about PEWS scores and describes ongoing national work by NHS England and the Royal College of Paediatrics and Child Health to develop a framework for recognising and responding to children at risk of deterioration. (AI summary)
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Dear Mr Walker
Thank you for your letter to Jeremy Hunt about the death of Parv Patel. I am responding on his behalf as the Minister with responsibility for Child Health.
I was very sorry to hear of Parv’s death.
Your report gives an overview of the circumstances surrounding Parv’s admission to hospital and noted the following concerns;
• Paediatric early warning system (PEWS) scores do not reflect current research into child illness; and
• PEWS scores may tend to act to distract doctors away from the fact that, despite a low PEWS score a child may be seriously ill.
NHS England are continuing to work towards developing a consensus view on a paediatric early warning system. There is at present no nationally recommended PEWS score. The complexities of developing a single score are a challenge. It would have to reflect the differing needs and requirements of all children from infants to teenagers, with a range of greatly different underlying healthcare conditions. Developing such a score is the subject of current research funded by the National Institute for Health Research.
NHS England, with the Royal College of Paediatrics and Child Health (RCPCH), is now examining the elements of a framework for the recognition and response to children at risk of deterioration, which would be a PEWS system .This system would include such aspects as a structured communication, escalation to senior staff and review and would not remove the professional clinical view or indeed the parental or carers views or concerns. It should also consider the wider elements of clinical handover and briefings. It is recognised that a clinician could be distracted from identifying a child’s deterioration if only the score is considered in isolation from other factors.
I have sent your report on to Carol Ewing, Vice President of Health Policy at RCPCH: and to Peter Lachman, the Deputy Medical Director for Safety at Great Ormond St and clinical lead for the RCPCH-led Situation Awareness For Everyone project, to inform their work in this area.
I hope that this information is helpful and I thank you for bringing the circumstances of Parv’s very sad death to our attention.
Thank you for your letter to Jeremy Hunt about the death of Parv Patel. I am responding on his behalf as the Minister with responsibility for Child Health.
I was very sorry to hear of Parv’s death.
Your report gives an overview of the circumstances surrounding Parv’s admission to hospital and noted the following concerns;
• Paediatric early warning system (PEWS) scores do not reflect current research into child illness; and
• PEWS scores may tend to act to distract doctors away from the fact that, despite a low PEWS score a child may be seriously ill.
NHS England are continuing to work towards developing a consensus view on a paediatric early warning system. There is at present no nationally recommended PEWS score. The complexities of developing a single score are a challenge. It would have to reflect the differing needs and requirements of all children from infants to teenagers, with a range of greatly different underlying healthcare conditions. Developing such a score is the subject of current research funded by the National Institute for Health Research.
NHS England, with the Royal College of Paediatrics and Child Health (RCPCH), is now examining the elements of a framework for the recognition and response to children at risk of deterioration, which would be a PEWS system .This system would include such aspects as a structured communication, escalation to senior staff and review and would not remove the professional clinical view or indeed the parental or carers views or concerns. It should also consider the wider elements of clinical handover and briefings. It is recognised that a clinician could be distracted from identifying a child’s deterioration if only the score is considered in isolation from other factors.
I have sent your report on to Carol Ewing, Vice President of Health Policy at RCPCH: and to Peter Lachman, the Deputy Medical Director for Safety at Great Ormond St and clinical lead for the RCPCH-led Situation Awareness For Everyone project, to inform their work in this area.
I hope that this information is helpful and I thank you for bringing the circumstances of Parv’s very sad death to our attention.