Martha’s Rule: A new era for patient safety

By Sian Stevens

Published February 22, 2024In: Clinical Negligence

From April 2024, ‘Martha’s Rule’ will be rolled out in hospitals across England, the NHS has announced.

The patient safety initiative, which will be rolled out to 100 NHS sites, will enable patients and families to seek an urgent review if their condition deteriorates.

The initiative follows a campaign set up by Merope Mills, who questioned doctors’ attitudes after her 13-year-old daughter Martha’s preventable death in hospital.

Martha sustained a rare pancreatic trauma after falling from her bike. She was admitted to a special unit where she developed and later died due to a failure to escalate her level of care. The parents said that they felt their concerns were ignored for their daughters worsening condition, and requests for her to be transferred to ICU were denied.

The launch of the national campaign will build on NHS England’s Worry and Concern pilots launched at seven trusts last year, which enabled escalation methods for patients’ and families’ concerns.

Under the new scheme, health staff at participating hospitals will be required to formally record daily insights and information about a patient’s health as observed by their parents and guardians. This will ensure that changes in behaviour or condition are noted by those who know the person best.

NHS chief executive, Amanda Pritchard, said: “Hearing about the heartbreaking loss of Martha and the experiences of her family has had a major impact for people right across the country, with parents, patients and NHS staff welcoming her parents’ call for a simple process to escalate concerns when they can see a loved one’s condition worsening.

“NHS teams have been piloting ways to better identify and respond in these cases over the last year, and the roll-out of a national programme to give patients and families 24/7 access to a rapid clinical review will now help ensure that those experiencing acute deterioration can be identified and treated much more quickly.

“I know I speak on behalf of all NHS staff when I thank Merope and Paul for their extraordinary campaigning and collaboration on this hugely important issue – while the need for escalation will hopefully only be needed in a small number of cases, I have no doubt that the introduction of Martha’s Rule has the potential to save many lives in the future.”

The initial roll-out will be reviewed across 2024/25 and will inform proposals for Martha’s Rule to be expanded further, subject to funding. It will also help to identify ways Martha’s Rule can be adapted cross other health care settings, including community and mental health hospitals.

Sian Stevens, Senior Associate and Legal Executive in the medical negligence team, commented: "We have worked closely with many families who have been in a similar position to Martha’s parents, and know first-hand how important this programme will be in providing a voice to patients, families and carers. Tragically, we hear of often being overlooked, and in many cases fatality would have been preventable had concerns of patients and their families been heard. Listening to concerns raised and improving detection and treatment are vital to patient safety. This scheme will help ensure that the best possible care is being given, and will give power to those that know the patient best, recognising the critical role they play in the patients care and treatment.”