NHS expands Martha's Rule to all emergency departments in England

The NHS is expanding Martha's Rule to all hospital emergency departments in England to help patients and families challenge staff and seek second opinions about their care if they want.

It is named after Martha Mills, who died aged 13 at King's College Hospital in London in 2021 after developing blood poisoning or sepsis. Her family's concerns were not listened to, which later prompted her parents, Merope and Paul, to change that culture by creating the rule.

Patients, loved ones and staff in A&E units will be able to call a dedicated phone number to trigger an urgent review if a patient's condition is deteriorating and they are concerned this is not being listened to.

The nationwide expansion starts now and should be complete by March 2028, following a successful trial at seven trusts. It is already being rolled out across all inpatient wards.

In 2022 a coroner ruled, external Martha would probably have survived if she had been transferred earlier to intensive care and given appropriate treatment.

She was in hospital after a bike accident left her with serious injuries to her pancreas.

During a family holiday, she had skidded on some sand while cycling and fell heavily onto the handlebars.

After a few weeks, she developed an infection and then signs of sepsis - when the body's response to an infection is overwhelming and ends up injuring its own tissues and organs - but this was not managed properly.

Prof Aidan Fowler, national director of patient safety at NHS England, said the expansion of Martha's Rule would give families and NHS staff "a critical new lifeline" to help improve care and save more lives.

Staff can themselves ask for a review from a different team if they are concerned the appropriate action is not being taken.

During the eight-month pilot at the seven trusts, 69 calls were made to dedicated Martha's Rule phone numbers, including some calls relating to acute deterioration following an urgent clinical review. In some cases, it led to a patient having immediate surgery or being transferred to intensive care.

Prof Fowler said: "Early testing has shown that Martha's Rule can work well in busy A&Es and builds on the evidence from our adult and children's wards, where thousands of calls have been made by patients, families and staff to date, with many leading to changes in treatment and potentially life-saving interventions."

Health minister Baroness Merron said the initiative was part of "wider efforts to put patient safety at the heart of the NHS."

Patients and their families can check with their local hospital or NHS trust where Martha's Rule is available by visiting the trust's website or asking hospital staff.

Scotland is beginning to use Martha's Rule and Northern Ireland is considering using it, while Wales has a similar scheme called Call4Concern.