We are pleased to hear the recent update that Martha’s Rule has now been implemented by every acute hospital in England. Martha’s Rule was first implemented by the NHS in May 2024 as a pilot scheme, with further expansion in April 2025. This means Martha’s Rule will now be covered in 210 acute facilities across England.
Martha’s Rule was introduced following the death of 13-year-old Martha Mills, who died in hospital in 2021, after developing sepsis following a bicycle accident. Her family’s concerns were not heeded. In 2022, a coroner found that if Martha had been moved to the intensive care unit sooner, she would have survived. The roll-out update was announced on what would have been Martha’s 18th birthday.
The rule gives patients and their loved ones the right to ask for a second opinion if they have concerns about their care. This involves a phone number at the hospital that they can call to request an urgent review from a critical outreach team.
Data from NHS England between September 2024 and June 2025 shows that:
- 4,906 Martha’s Rule calls were made, with the highest proportion (71.9%) made via the family escalation process
- 2,132 Martha’s Rule escalation calls (43%) related to acute deterioration
- Of those, 241 calls resulted in potentially life-saving escalations of care. including93 urgent admissions to high dependency or intensive care units and 49 transfers to another enhanced level of care or to a tertiary centre.
Martha’s mother, Merope Mills, said she is delighted that more people will get access to the rule but called for it to be implemented more widely, including across the UK and in maternity care. Heath secretary Wes Streeting echoed those recommendations, adding that he had “seen and heard similar experiences where mothers were not listened to in maternity services”. He has also promised that he would share the latest results with Scotland, Wales and Northern Ireland colleagues.
Ally Taft, Partner at Medical Accident Group said “I really welcome the wider implantation of Martha’s Rule, and it has clearly already saved lives. The next step must be to implement this in maternity units across the country. We see many cases where mothers are not listened to, with catastrophic outcomes for unborn and newborn babies. Maternity services are failing families at present, and Martha’s Rule could help towards ensuring people are listened to in the maternity environment.”
