NHS data reveals hundreds of patients have benefited from potentially life-saving changes to their care, thanks to a pilot scheme introduced following the death of Martha Mills in 2021, aged just 13, after developing sepsis in hospital.
As a result of the success of the pilot, which was introduced across 143 sites in May 2024, Martha’s Rule is now available in every acute hospital in England.
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 condition, or that of a loved one, deteriorates and they are concerned this is not being responded to.
Staff too can ask for a review from a different team if they are concerned the appropriate action is not being taken.
Martha Mills was admitted to hospital with a pancreatic injury after falling off her bicycle. Her family’s concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier.
The data
Between September 2024 and June 2025, 4,906 calls were made to Martha’s Rule helplines to escalate concerns about care – leading to 241 potentially life-saving interventions being triggered.
The new data published by the NHS shows almost three quarters (71.9%) 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 (794) 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.
Consistent branding and materials for Martha’s Rule has been rolled out, 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.
The introduction of Martha’s Rule across all acute sites has been welcomed by the Health Secretary, Wes Streeting, as well as healthcare professionals, patient groups and Martha’s parents.
Merope Mills and Paul Laity, say: “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.”
Dr Ben Richardson, Paediatric Consultant and Yorkshire and Humber Clinical Lead for the regional Martha’s Rule pilot, says: “Working as part of a local, regional and national team, it’s been amazing to see, in such a short space of time, how so many healthcare professionals have moved from apprehension about how to widely implement Martha’s Rule to being thoroughly invested in the culture change that underpins its success.
“We all realise it’s not just about being able to tick a box for each component of Martha’s Rule, but to really think deeply about how to advocate for the patients, their families and the voice that is seldom heard.”
