The campaign to introduce Martha’s Rule spearheaded by Martha's mother Merope Mills highlighted the importance of voicing concerns, challenging decisions, and calling for second opinions, ‘which could have prevented the unforgivable mistakes made in her case’.

Merope Mills documented Martha’s story, sharing the impact on her family and her wish for improved patient safety. You can read the article here - ‘We had such trust, we feel such fools’: how shocking hospital mistakes led to our daughter’s death’

What is Martha’s Rule? 

Martha’s Rule encompasses three key components that promise to revolutionise patient care within the NHS.

• Firstly, it mandates that all NHS staff have 24/7 access to a rapid review from a critical care outreach team, enabling swift intervention in cases of concern.
• Secondly, patients, families, carers, and advocates will also have access to the same rapid review service, empowering them to voice their worries and ensure timely responses to their loved ones’ conditions.
• Thirdly, a structured approach will be implemented to gather daily updates on patients’ conditions directly from patients and their families, fostering transparent communication and informed decision-making.

The implementation of Martha’s Rule will commence with a phased approach, beginning with select NHS trusts that already possess a 24/7 critical care outreach capability. The initial sites will serve as pioneers, shaping and refining the standardised approach to Martha’s Rule, informing development of wider national policy proposals for Martha’s Rule that can be expanded in a phased way across the NHS from 2025/26. This will also involve the identification of ways to develop an adapted Martha’s Rule model across other settings including community and mental health hospitals.

Martha’s Rule will complement existing initiatives aimed at improving the identification of deterioration. This builds on the NHS England’s Worry and Concern Improvement Collaborative, introduced in 2023, which has been instrumental in testing and implementing methods for patients, families, and carers to escalate concerns about deterioration, thereby enhancing patient safety and outcomes.

Crucially, Martha’s Rule will be integrated into the ‘PIER’ framework, which aims to Prevent, Identify, Escalate and Respond to physical deterioration. By embedding Martha’s Rule within this comprehensive framework, the NHS hopes to foster a culture of proactive patient care, where staff are supported in managing deterioration effectively.

In essence, Martha's Rule represents a significant stride towards patient-centred care within the NHS. By prioritising patient concerns, enhancing communication channels, and fostering a culture of transparency and collaboration, Martha’s Rule heralds a new era of healthcare delivery. As Martha’s legacy lives on, her rule will continue to inspire positive change and shape the future of healthcare in England.

You can find more information about Martha’s Rule on the NHS England website.