Hospital tool for identifying unwell children ineffective in general practice

Researchers at the Wales Centre for Primary and Emergency Care Research (PRIME Centre Wales), funded by Health and Care Research Wales, have found that a major clinical tool used in hospitals, is unsuitable for general practice in its current form.

The National Paediatric Early Warning Score (National PEWS), recently introduced in England, helps healthcare professionals identify seriously unwell children in hospitals. PRIME Centre Wales, in collaboration with primary care experts from the Universities of Bristol, Oxford, and Liverpool, tested its suitability for general practice.

Dr Kathryn Hughes, Senior Clinical Lecturer at PRIME Centre Wales, said: “The National PEWS score wasn’t designed for general practice. Like many hospital-developed tools, it doesn't perform well in this setting. A modified version might perform better, but a tool developed specifically for general practice is more likely to be accurate and acceptable.”

The study involved analysing a large dataset of 6,703 children under five with acute illnesses who visited GPs in England and Wales. Researchers tested two scoring systems: the National PEWS and the Liverpool Quick Sequential Organ Assessment.

The research underscores the importance of validating clinical decision-making tools in general practice and offers crucial insights into the National PEWS tool’s accuracy for assessing children in this context.

The National PEWS records clinical observations such as heart rate and oxygen levels to track changes and identify seriously unwell children, but it is not suitable for use in general practice in its current form.

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