Major patient safety initiative begins roll-out


The 143 hospital sites that will test and roll out Martha’s Rule in its first year have been announced by NHS England. This major patient initiative aims to provide a consistent and understandable way for patients and families to seek an urgent review if their condition, or that of a loved one, deteriorates and they are concerned this is not being responded to.

The initial target was to enrol at least 100 sites, but due to significant interest from frontline clinicians this has been expanded, meaning this first phase of the programme will be in place at 143 locations across the country by March 2025.


Martha’s Rule

Martha’s Rule is named after Martha Mills, who died from sepsis aged 13 in 2021 – having been treated at King’s College Hospital in London – due to a failure to escalate her to intensive care, and after her family’s concerns about her deteriorating condition were not responded to.

Extensive campaigning by Martha’s parents, Merope and Paul Laity, supported by the cross-party think tank Demos, saw widespread support for a single system that allows patients or their families to trigger an urgent clinical review from a different team in the hospital if the patient’s condition is rapidly worsening and they feel they are not getting the care they need.

The scheme is to be made up of three components to ensure concerns about deterioration can be swiftly responded to.

Firstly, an escalation process will be available 24/7 at all 143 sites, advertised throughout the hospitals on posters and leaflets, enabling patients and families to 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, alongside this, clinicians at participating hospitals will also formally record daily insights and information about a patient’s health directly from their families, ensuring any concerning changes in behaviour or condition noticed by the people who know the patient best are considered by staff.

NHS England is working with Martha’s parents to develop materials to advertise and explain the initiative in hospitals across the country, to ensure it is something that all staff, patients and their families can recognise.

The full list of hospital sites involved in this test is available here.

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