'Worried they're getting worse' rolls out across all NSW public hospitals

A tool that recognises parents, families and carers know their children best is being rolled out across all NSW public hospitals. Developed by the Clinical Excellence Commission and based on new research from Monash Health, the tool — ‘Worried they’re getting worse’ — will require healthcare workers to regularly ask families: ‘Are you worried they are getting worse?’

The question is designed to help capture important changes in a child’s condition and will be embedded in paediatric and neonatal observation charts in ED and inpatient units across NSW. If parents or caregivers indicate they believe their child is getting worse or deteriorating, this will trigger a review by a senior healthcare worker.

The new hospital initiative is aimed at better supporting parents to raise concerns about their child’s condition if they feel it is getting worse; its question recognising that parents and carers are oftentimes able to detect early changes or deterioration in their child’s behaviour or temperament, which could signal a clinical concern.

“Parents and carers can recognise small changes in a child’s condition sometimes before healthcare workers can observe changes in things like heart rate or breathing,” NSW Health Minister Ryan Park said. “Feedback from parents and carers is critical in capturing information about a child who is becoming seriously unwell.”

First trialled in March at Hunter New England Local Health District, the tool began its statewide rollout at The Sydney Children’s Hospital Network on 21 July. The tool will be implemented by all NSW public hospitals by October, the state government advised, with the program to be extended into maternity and adult wards in early 2026.

“We know staff right across the NSW public health system work incredibly hard to deliver the highest quality of care for patients and we need to ensure the right systems are in place that support them to continue to do so,” Secretary of NSW Health Susan Pearce AM said.

“Really listening to parents, carers and family members is critical when caring for children in hospital and this new initiative recognises the vital role they play in their child’s care alongside our excellent healthcare professionals.

“By working together, we can strengthen patient safety for children and babies and provide an environment where parents and carers are encouraged and empowered to raise concerns.”

Separately, the REACH program is also accessible in all NSW public hospitals, with work underway to strengthen this safety net. Available for parents and carers when they have concerns their child is becoming seriously unwell, a REACH call prompts an urgent patient review by a senior health worker.

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