What is Martha's Rule?
The purpose of Martha’s Rule is to provide a consistent and understandable way for patients and families to seek an urgent review if their or their loved one’s condition deteriorates, and they are concerned this is not being responded to.
Martha Mills died in 2021 after developing sepsis in hospital. Martha had been admitted with a pancreatic injury after falling off her bike whilst on holiday. Martha’s family concerns about her deteriorating condition were not responded to on several occasions and in 2023 a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier.
In response to this and other cases related to the management of deterioration, the Secretary of State for Health and Social Care and NHS England committed to implement ‘Martha’s Rule’; to ensure the vitally important concerns of the patient and those who know the patient best are listened to and acted upon.
In April 2024, national implementation of Martha’s Rule began. Once NHS hospitals have fully implemented all components, 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 someone’s condition.
Martha's Rule has three components:
- Patients will be asked, at least daily, about how they are feeling, and if they are getting better or worse, and this information will be acted on in a structured way.
- All staff will be able, at any time, to ask for a review from a different team if they are concerned that a patient is deteriorating, and they are not being responded to.
- This escalation route will also always be available to patients themselves, their families and carers and advertised across the hospital.
Health Innovation North West Coast’s Patient Safety Collaborative (PSC) is working with acute trusts (phase 1 and 2) to test and implement Martha’s Rule through supporting shared learning and quality improvement.
Landmark for Martha's Rule implementation
We convened acute trusts from across our footprint to an event at Alder Hey to mark the end of the first year of testing & implementation. You can read more about this here.