Royal College of Paediatrics and Child Health

“We note your continued concern this is undertaken on paper and is not simply a local issue.”

“We are currently in the process of audit, review and revision and update of these standards, to be published later in 2025.”

“We will ensure we signpost to this accordingly”

“I intend to make a prevention of future deaths report”

“We will continue to be strongly supportive of this initiative and support the need for early escalation of care for those patients in whom it is not possible to undertake vital signs.”

“We have been collaborating with NHS England and the Royal College of Nursing to develop a single national PEWS for England since 2018 and are supportive of equivalent processes across the UK”

“Emergency clinicians with responsibility for the care of children receive training in how to assess risk and immediately manage children's mental health needs and support their family/carers”

“The trust emergency department electronic patient records do not show how many times a patient has presented to hospital with the same signs and symptoms during their current illness”

“We would look to the National Institute for Healthcare Excellence to take a lead on this work to help develop a further evidence base or consensus guidance in this complex area of clinical practice.”

“RCPCH are currently reviewing our Emergency Care Standards and the information within your report has been shared with our Emergency Care Committee to inform this work.”

“Following receipt of your report, senior clinical advisors within the patient safety team at NICE have reviewed the concerns raised. They have advised that incidence of VTE in children is low -1.4-2.1 cases per 100,000 children per year. This is much lower than the incidence in adults. In children, the most common risk factors for VTE are the presence of a central venous catheter (CVC) or conditions such as congenital cardiac disease. Other risk factors include inherited hypercoagulable state (as”

“The College will be sharing information and suggestions for local improvement from your report with our paediatric members via its patient safety portal.”

“introduced a formal supervisor assessment that the trainee is ready to be on the tier 2 rota with remote supervision (i.e., a consultant on call from home). To agree that a trainee is ready for this step there needs to be agreement that there is evidence of: - Neonatal capabilities. - General paediatric capabilities. - Neonatal Life Support & Advanced Paediatric Life Support course, or equivalent. - Mandatory procedures (including airway maintenance”

“The RCPCH endorsed this decision alongside the Royal College of Emergency Medicine, Royal College of General Practice, and NICE following a review by the NHS England Clinical Advisory Group and UKHSA Group A Strep Incident Management team, which assessed the overall clinical risk-benefit, including antimicrobial utilisation and potential for resistance and harms”

“Paediatricians would welcome an effective tool to help with the identification of Group A Strep, and there is a need for more research relating to their validity, including the appropriate levels of sensitivity and specificity in their performance for testing under-fives”

“The College will be sharing information and suggestions for local improvement from your report with our paediatric members via its patient safety portal”

“We recommend the development of similar guidelines for GAS.”

“consider the facts of the case”

“The 111 algorithm has been subject to modification in the light of these events, but I remain concerned that there is: a. no detailed assessment of the degree of parental concern”