The Paediatric Admission Guidance in the Emergency Department (PAGE) score

Our study designed to support better decision-making in children’s emergency care has broken recruitment records for 2018-19. 32724 children were recruited during 2018-2019 with a further 11777 before the end of the study (31 July 2019) making a grand total of 44,501 children involved.

Funded by the National Institute for Health Research (NIHR), the PAT-POPS (Pennine Acute Hospitals NHS Trust Paediatric Observation Priority Score) study (which resulted in The Paediatric Admission Guidance in the Emergency Department (PAGE) score – soon to be published) was designed to support practitioners when making decisions about whether children need to be admitted to hospital or should be discharged to recover at home. It has been conducted over 18 months in three different emergency departments and an urgent care unit.

The study was carried out in partnership between the University of Salford, the University of Manchester and the University of Leicester, together with Leicester Hospitals and the Northern Care Alliance NHS Group.

It was the highest recruiting study in England in 2018-19, with the large sample size meaning that findings can provide significant insight into which factors have the greatest impact on whether children need to be admitted to hospital or can be safely discharged.

It is also the highest ever recruiting paediatric study and third highest recruiting study of any specialty in the history of the NIHR Clinical Research Network.

This study highlights the importance of research partnerships between the university and the NHS, particularly the Northern Care Alliance NHS Group, in order to improve outcomes for children and young people. It marks a determination to bring together clinicians and academics to find solutions to significant health and wellbeing problems.

We’re really grateful to all the young people and their families for allowing us to use these routine observations. It is vital that children and young people are treated in the most clinically appropriate environments and that systems are in place to identify those who need to be admitted and others who could be reassured and allowed home or who could access other services. Although children and young people didn’t have to have any extra tests or procedures in this study, we appreciate that it can be stressful coming to hospital, so it is really fantastic that more than 44,500 children were able to help with our study.

With so many families agreeing to share this information with us, we now have really strong evidence to feed into our guidelines. These sorts of tools and checklists are widely used in all areas of the NHS to make sure we’re consistent in our decision-making and take all factors into account.

This study, and the associated programme of research, highlight the enormous benefits realised through establishing effective partnerships with our key academic partners. Research is closely linked with clinical care and these recruitment figures mean that more people than ever are being given the chance to test new medicines and to contribute to improvements in diagnosis, care and treatments.

This work uses data provided by patients and collected by the NHS as part of their care and support and would not have been possible without access to this data. The NIHR recognises and values the role of patient data, securely accessed and stored, both in underpinning and leading to improvements in research and care. www.nihr.ac.uk/patientdata

This study presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0815-20034). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

Funder: The UK National Institute for Health Research (NIHR): £316,731

Team: Professor Andrew Rowland, Professor Tony Long, Dr Joan Livesley, Professor Steve Woby, Mr Calvin Heal, Mr Calvin Heal, Dr Sarah Cotterill, Dr Damian Roland, Ms Natalie Garratt, Dr Laura Bonnett, Mr Stephen Brown