‘Martha’s Rule’ to be rolled out to A&E at ALL hospitals in England – what it means for you and your loved ones

ALL A&E departments will give patients the right to a second opinion as the NHS rolls out Martha’s Rule. The policy, named after Martha Mills who died of sepsis aged 13 after doctors failed to act on her parents’ concerns, provides a phone line to fast-track extra help. A coroner ruled Martha Mills, who died of sepsis aged 13, would likely have survived if she received intensive care sooner Credit: PA Doctors say they are more likely to miss warning signs as hospitals are so busy (stock image) Credit: Alamy Patients, relatives and staff can use it to force a rapid review if they are worried someone is deteriorating because they are not getting the right care. It is already used on wards and will become part of casualty by March 2028. Sign up for the Health newsletter Thank you! It could help to catch sepsis or deadly infections sooner so they get quicker treatment. Professor Aidan Fowler, director of patient safety at NHS England, said: “A&Es see some of our most vulnerable patients so the ability to raise concerns about deterioration quickly and trigger a rapid review of care is essential. “By expanding Martha’s Rule we are giving more patients, families and NHS staff a critical new lifeline to help improve care and save more lives.” Between September 2024 and July 2026 there have been more than 19,000 calls made through Martha’s Rule. July’s monthly total was the highest ever at 1,678, equal to 54 per day. The decision to roll it out in A&E comes after emergency departments in England had their busiest summer on record, with a combined 7.27million visits in June, July and August. Most read in Health More than 40,000 people per month spend longer than 12 hours in A&E waiting for a bed on a ward. Around 3,000 per day are kept in corridors and side rooms while they wait. Dr Ian Higginson, president of the Royal College of Emergency Medicine, said: “Patients should feel safe in our departments, but we recognise that sometimes things can get missed by even the most skilled clinicians in A&E. “Unfortunately, the risk of this happening is much greater given the overcrowded and understaffed environments they are being expected to work in. “We welcome Martha’s Rule being rolled out further.” An eight-month pilot had 69 calls and saw patients sent for urgent surgery or intensive care after their case was reviewed. Hospitals will also be expected to extend it to maternity and neonatal units by March 2028. Health Minister Baroness Gillian Merron said: “This will give patients, families and staff another way to speak up when they are worried that someone’s condition is getting worse, ensuring concerns are acted on quickly. “This is part of our wider efforts to put patient safety at the heart of the NHS.” Martha's Rule Named after teenage Martha Mills - who died of sepsis despite her parents' pleas that she wasn't receiving the necessary care - 'Martha's rule' gives patients a right to second medical opinion. Martha, 13, died from sepsis in 2021 after medics failed to boost her to intensive care when her parents raised concerns about her rapidly deteriorating condition. The rule will give patients and their families access to a rapid review if they are worried about their condition. NHS England pledged to introduce ‘Martha’s Rule’ to at least 100 hospitals in February. But it announced today that 143 sites will roll out the rule change by March 2025 following “significant interest” from hospitals across the country. The purpose of Martha’s Rule is to provide “a consistent and understandable way for patients and families to seek an urgent review if their or their loved one’s condition deteriorates and they are concerned this is not being responded to”, NHSE said. Described as a “three-step safety net”, the rule will be made up of three components. Firstly, an escalation process will be available 24/7 at all the 143 sites. This will be advertised throughout the hospitals on posters and leaflets, so patients and families can contact a critical care outreach team that can swiftly assess a case and escalate care if necessary. Secondly, NHS staff will also have access to this same process if they have concerns about a patient’s condition. Finally, clinicians at participating hospitals will also be obligated to formally record insights and information about a patient’s health provided by their families daily. This will ensure that any concerning changes in behaviour or condition noticed by the people who know the patient best are considered by staff, NHSE said. Read more on ‘Martha’s rule’ here. Comment now