What is ‘Martha’s Rule’ and what does it mean for future hospital care?

‘Martha’s Rule’ is a new patient safety initiative that is being rolled out across at least 100 English NHS hospitals from April 2024. It allows patients, loved ones and NHS staff with concerns about a patient whose condition is deteriorating to trigger an urgent review of their care and condition.

This rapid escalation review is carried out by an independent critical care team not involved in the patient’s treatment and will be available around-the-clock 24/7.

The team will also formally record families’ observations of the patient’s condition or behaviour, giving a voice to concerned loved ones.

Martha’s Rule was introduced following extensive campaign by, Merope Mills and Paul Laity, the parents of Martha Mills, a 13 year-old girl who died of sepsis at King’s College Hospital in London.

Martha had sustained an injury to her pancreas after falling off her bike. Despite her deteriorating condition and her parents’ concerns that she was showing symptoms of sepsis and needed to be moved to intensive care, Martha was not and she later sadly died. An inquest found she may have survived if the parents’ concerns had been listened to and she had been moved to intensive care sooner.

Speaking to The Guardian, Martha’s parents said: “We believe Martha’s Rule will save lives. In cases of deterioration, families and carers by the bedside can be aware of changes busy clinicians can’t. Their knowledge should be treated as a resource.

We also look to Martha’s Rule to alter medical culture: to give patients a little more power, to encourage listening on the part of medical professionals, and to normalise the idea that even the grandest of doctors should welcome being challenged.”

Speaking on the NHS England website, NHS chief executive, Amanda Pritchard, said: “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…..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 introduction of Martha’s Rule comes alongside other measures to improve the identification of deterioration, including the rollout last November of a new early warning system for staff treating children.

The Paediatric Early Warning System is built on similar processes already in place for adult, newborn, and maternity services. Here clinicians are able to track potential deterioration by formally recording changes in vital signs like blood pressure, heart rate, oxygen levels and levels of consciousness, with different scores representing the level of concern.

How we can help

If you have queries about this article or treatment you have received, and would like to speak with one of our medical negligence specialists, call us for a free consultation on 02920 391773 or contact Linda Williams on linda.williams@geldards.com.

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