Martha’s Rule is set to be rolled out across accident and emergency (A&E) departments and waiting rooms in England following a successful trial.
The move is designed to strengthen patient safety by providing a dedicated process for escalating concerns when a patient’s condition is worsening.
Why is Martha’s Rule being extended?
The decision follows a trial at a number of National Health Service (NHS) trusts, which highlighted the benefits of giving patients, families and healthcare professionals a dedicated process to request an urgent review when they are concerned that a patient’s condition is deteriorating.
As a result, NHS England has announced that Martha’s Rule will be introduced across A&E departments and waiting rooms in England. The phased implementation is expected to be completed by March 2028.
What is Martha’s Rule?
Martha’s Rule is a patient safety initiative designed to support the earlier identification of deterioration in hospital patients.
It is named after 13-year-old Martha Mills, who died in 2021 after developing sepsis while receiving treatment for a pancreatic injury sustained in a cycling accident.
During Martha’s admission, her family became increasingly concerned about her condition. Despite raising those concerns, she was not transferred to intensive care. In 2023, a coroner concluded that Martha would probably have survived had she been moved to intensive care sooner.
Following a campaign led by Martha’s parents, NHS England introduced a clearer system that allows patients, families and healthcare professionals to request an urgent review if they believe a patient’s condition is worsening.
How does it work?
Patients, families and carers should first raise concerns about a worsening condition with the clinical team. If they feel those concerns have not been properly addressed, they can call a dedicated telephone number to request a rapid review by a separate clinical team.
Healthcare professionals can also use the process if they believe a patient’s condition is deteriorating and feel their concerns have not received an appropriate response.
The rule is not intended to replace discussions with the treating team or provide a general route for obtaining a second opinion. Instead, it acts as an additional safeguard when there are concerns that a patient’s condition may be declining and further action is needed.
What should patients and families do if they are concerned?
Anyone who notices that their own condition, or the condition of someone they are supporting, is getting worse should speak to the healthcare professionals responsible for their care.
They should explain what has changed, when they first noticed it and why they are concerned. If they feel the issue has still not been addressed, the patient or their family can ask whether Martha’s Rule is available and how to request a rapid review.
The rollout of Martha’s Rule across A&E departments represents a significant step in strengthening patient safety and helping to ensure concerns about deteriorating patients are heard and acted on.
