Industry News | Sep 12, 2025 | No Comments |
Update on Martha’s Rule
September 2025: Rollout of Martha’s Rule in England
Announced poignantly on the day that would have been her 18th birthday, Martha’s Rule has now been rolled out in all acute hospitals in England.
Martha Mills died of sepsis in hospital aged 13, after her parents’ concerns about her deteriorating condition were ignored. They have since campaigned for the right to an urgent second opinion if people are concerned about a loved one’s treatment.
Successful trial carried out
Between September 2024 and June 2025, there were 4,906 calls made to Martha’s Rule helplines to escalate concerns about care. This led to 241 potentially life-saving interventions being triggered.
New data published by the NHS shows almost three quarters of calls have been from families seeking help, with 720 calls leading to changes in care. This could include patients receiving a new medication such as an antibiotic.
Almost 800 calls led to clinical concerns such as medication or investigation delays being addressed. A further 1,030 calls helped to resolve communication and discharge planning issues.
Martha’s Rule is a major patient safety initiative in hospitals encouraging patients, families and carers to speak to the care team if they notice changes in someone’s condition.
It also provides them with a way to seek an urgent review if their or their loved one’s condition deteriorates – and are concerned this is not being responded to.
Urgent review also available to hospital staff
Staff can themselves ask for a review from a different team if they are concerned the appropriate action is not being taken.
The NHS has rolled out consistent branding and materials, including posters around hospitals, to ensure the programme is easy to understand for patients and their families.
Full evaluation of the programme is ongoing and will help inform proposals to expand to other settings.
Merope Mills and Paul Laity, Martha’s parents, said:
“It would be Martha’s 18th birthday today, another milestone she has missed as a result of the poor care and hospital errors that led to her unnecessary death.
“We feel her absence every day, but at least Martha’s Rule is already preventing many families from experiencing something similar.
“The figures prove that lives are saved when patients and families are given power to act on their suspicions when they feel doctors might have got it wrong and their voice isn’t being heard.
“We are pleased to know more hospitals are taking up Martha’s Rule and look forward to a time when every patient in the UK knows about the initiative and has easy access to it”.
Professor Meghana Pandit, NHS National Medical Director, said:
“There is no shadow of a doubt that Martha’s Rule is having a transformative impact on the way hospitals are able to work with patients and families to address deterioration or concerns about care.
“There have now been almost 5,000 calls made to the hotlines, with hundreds of potentially life-saving interventions triggered, which is why we are now expanding Martha’s Rule to all acute hospitals in England.
“I want to take this opportunity to thank Merope and Paul who have campaigned tirelessly on this issue and continue to work with us to ensure Martha’s Rule is at the centre of our efforts to boost patient safety and quality of care.
“I also want to thank clinical staff up and down the country who have swiftly implemented this potentially lifesaving intervention and ensured its success”.
The Patient Safety Commissioner, Professor Henrietta Hughes, said:
“I am delighted to see that Martha’s Rule has now been rolled out across all acute trusts so even more patients can benefit from potentially lifesaving treatment. Martha’s Rule is transforming healthcare culture and shows the benefits of working in partnership with patients”.
November 2023: Recommendations for Martha’s Rule from PSC
There is now considerable momentum behind “Martha’s Rule”, which came up in the article about sepsis care in last week’s Independent Living newsletter.
It would enable patients’ families to get a rapid second medical opinion if they are concerned about their condition.
The patient safety commissioner, Dr. Henrietta Hughes, has drafted recommendations on implementing the system, at the request of Secretary of State Steve Barclay.
Rapid review of acute in-patients
Following a series of “policy sprints”, the PSC is recommending that all staff have access to a 24/7 escalation route for rapid review of acute in-patients and that this route is also available to patients, their families, carers and representatives.
This is Martha’s Rule
The recommendations on rapid review were finalised through collaborative working with people including Martha’s parents, Merope Mills and Paul Laity, the Patients Association, and Polly Curtis, chief executive of Demos.
The PSC believes the approach adopted by everyone involved demonstrates how they can work collaboratively, inclusively and helpfully to change the culture of the health service and reduce the risk of severe harm to patients.
The recommendations in summary:
• we must implement a structured approach to obtain information relating to a patient’s condition directly from patients and their families at least on a daily basis. In the first instance this will cover all in-patients in acute and specialist Trusts.
• all staff in those Trusts must have 24/7 access to a rapid review from a critical care outreach team who they can contact should they have concerns about a patient.
• all patients, their families, carers and advocates must also have access to the same 24/7 rapid review from a critical care outreach team which they can contact via mechanisms advertised around the hospital and more widely if they are worried about the patient’s condition.
Over to the Secretary of State
It is now up to secretary of State Steve Barclay to respond to the recommendations and put forward a timetable for the implementation of Martha’s Rule.
The letter to the Secretary of State setting out the recommendations is here (PDF file will open in a new browser tab or window).
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Further reading and resources
You can read more about the work of the PSC on their website (external link will open in a new browser tab or window)
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