What is Martha's rule and when will it be introduced?

Martha’s rule means that patients, families, carers and staff will have round-the-clock access to a rapid review from a separate care team if they are worried about a person’s condition.

Following the tragic death of their daughter in 2021, parents of Martha Mills have campaigned for close to three years for the introduction of Martha’s rule which will be phased in to NHS hospitals from April this year. 

The system, which gives seriously ill patients easy access to a second opinion if their condition worsens, has been introduced due to the unnecessary death of Martha to sepsis. 

At the age of 13, Martha was admitted to hospital following a bike accident for injury to her pancreas. She developed sepsis in hospital and despite her parents and asking multiple consultants, did not receive adequate care. 

An inquest after her death found that with the right treatment, Martha could have survived. 

Ms Mills said: ‘We told three different consultants that we were worried about her and we were just told she would be fine and this was a normal infection she had. And when I had my doubts, still, I had nowhere to go. There was no ripcord to pull. I just had to trust the doctors.’ 

The parents hope that with this new system, many lives will be saved. 

How will Martha’s rule work? 

In a statement from the NHS, the three components of the rule are set out as:

  1. All staff in NHS 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.
  2. 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. This is Martha’s Rule.
  3. The NHS must implement a structured approach to obtain information relating to a patient’s condition directly from patients and their families.

If a patient or carer is seeking rapid review, senior doctors and nurses specialising in acute care will be asked to respond to their condition and provide a second opinion.

When will the rule be phased in?

At least 100 hospitals will be asked to sign up for the scheme starting in April 2024, these facilities will be provided with extra funding for creating promotional materials for Martha’s rule to ensure patients are aware of their entitlement. 

The statement reads: ‘These provider sites to devise and agree a standardised approach to all three elements of Martha’s Rule, ahead of scale up to the remaining sites in England in the following years.’

Read more about Martha’s rule here

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Information written by the talkhealth team

Last revised: 22 February 2024
Next review: 22 February 2027