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Implementing the new PEWS in the North West Coast

Blog posted by: Verity Mather, PEWS Project Manager, 15 November 2022.

When I began this project to help implement the new Paediatric Early Warning Score (PEWS) I had concerns that few would have the capacity to engage. How wrong I was. Within weeks all the teams really welcomed the idea of getting on board. 

NHS England has been working with the Royal College of Paediatrics and Child Health and the Royal College of Nursing to standardise the new Paediatric Early Warning Score (PEWS) across all NHS systems. 

The Patient Safety Collaboratives which are co-ordinated by the Innovation Agency and fellow AHSNs, have supported the delivery of the NHS System-wide Paediatric Observations Tracking (SPOT) programme since April 2021. This work has focused on a consistent and common language approach, to promptly recognise and respond to the unwell infant, child, or young person. 

Early on we met with the test sites’ senior teams. These included directors of nursing, clinical leads, matrons, and practice educators. Our focus was to support them in how best to lead on the testing of the new PEWS. These staff were then engaged with on a fortnightly to monthly basis. As the testing progressed, we offered separate sessions with trusts. 

Our goal was to support the test sites to think creatively and not be afraid to take risks during this improvement journey. As this work progressed, I found myself asking the teams questions such as ‘How can we make this work?’ and ‘Who has the power to drive this change?’   

As testing evolved, I could see the teams becoming less afraid to fail or experience setbacks when trying to implement this improvement.  

This national testing process has been unique in its approach to engaging clinical teams. I attended weekly SPOT feedback sessions alongside the test sites and was amazed at the commitment shown by clinical staff. They never failed to offer their insight and expertise, always against the backdrop of real clinical pressures. 

As well as our monthly collaboratives which we used to check in with the test sites, we held quarterly virtual learning events. This gave us the opportunity to share best practice across both the acute trusts and any other paediatric clinical areas in the region. We covered a range of topics such as addressing health inequalities and the impact of parental concern when using the new PEWS. Most importantly, the test sites had the opportunity to share their progress and gain peer support to navigate any challenges.  

The trusts continue to collaborate as a system, which puts them in a strong position to implement the new PEWS across the North West Coast. I know that all this effort will have a positive impact on patient safety and the learning shared. They are a determined and passionate group of staff and I wish them all every success as this work continues to grow. 

Information and resources to support this piece of work can be found here.

Verity Mather

Innovation Agency Project Manager 



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