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Martha’s rule proving ‘transformative’ to patient care, in initial roll-out across England

The initial roll-out of Martha’s rule across hospitals has yielded positive results, as patients and their families gain more control over treatment plans.

The new rule allows patients, their families and NHS staff to escalate concerns of the deteriorating health of a patient, and call for an urgent review of their condition and care. It was implemented after 13-year-old Martha Mills died in 2021 from sepsis after her family’s concerns of her condition were not responded to, resulting in her treatment not being escalated as required.

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The roll-out of Martha’s rule by the NHS was extended to 143 hospitals across England, already yielding ‘life-changing interventions,’ according to Dr Aidan Fowler, NHS national patient safety director and Senior Responsible Officer for the programme, as the rule amplifies the voices of patients and families with regards to their care. ‘In addition to providing a valuable failsafe to identify deterioration, this is increasing the sensitivity of our own monitoring as families and staff are very sensitive to changes in patients they know well.’

Between September and October 2024, 573 calls were made by patients, families, carers and NHS staff to urgently review the care of a patient. Of these calls, 50% resulted in a clinical review for acute deterioration, with one in five reviews resulting in a change to the patient’s treatment plan, such as prescribing life-saving antibiotics. Alongside this, 14 patients also required an urgent transfer to the ICU. Wes Streeting, Health and Social Care Secretary regarded the initial results as ‘transformative’.

‘The roll-out of Martha’s Rule is already playing a role in building a safer NHS by putting patients and their families at the heart of discussions about their healthcare, and early indications are that it could have a transformative impact. This Government is committed to making sure every patient is heard,’ said Mr Streeting.

The impact of the rule will be observed across the initial 143 hospitals over the course of a year, with plans for NHS England to finalise proposals to implement it across all acute hospitals.