A new patient safety initiative, developed following the death of teenager Martha Mills, is being piloted at both Chelsea and Westminster and West Middlesex University Hospitals. Once fully implemented, 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.
What is Martha’s Rule?
Martha’s Rule means that in the event of a suspected deterioration or serious concern on the part of a patient on a hospital ward, or their family or carer, they would have the right easily to call for a rapid review or second opinion from an ICU/HDU doctor within the same hospital.
Martha Mills died in 2021 after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling off her bike. Martha’s 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 3 proposed components of Martha’s Rule are:
- 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.
- 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.
- The NHS must implement a structured approach to obtain information relating to a patient’s condition directly from patients and their families at least daily. In the first instance, this will cover all inpatients in acute and specialist trusts.
When to use the service
- If you are a patient and feel your condition is worsening
- If you are a relative, friend or carer concerned about a patient’s condition
- If a patient’s condition has changed and you feel the ward team hasn’t addressed it
- If you have ongoing concerns after you have spoken to the ward nurse or doctor
To report problems with your hospital bed, room, food, parking or any other general issues, please speak to your nurse, ward manager or PALS.
Using this service will not negatively affect the patient’s care in any way. Healthcare professionals recognise that sometimes the patient or a close loved one can see that something is wrong before the healthcare team does. No one knows your healthcare needs, or those of your loved one, better than you and your family.
How to use the service
The service is open 24 hours a day, 7 days a week. Call 020 3315 4044.
When you call, you will be asked which hospital you are at, and this will connect you to the appropriate person. You will be asked:
- Which hospital are you calling from (Chelsea or West Middlesex)?
- Who are you concerned about?
- What are you most concerned about right now?
- Are there any healthcare staff on the ward who can assist until we arrive?
The response team, who already work closely with hospital colleagues when a patient is very unwell, will discuss the concern and assess the patient if necessary.
You can call at any time. If you don’t get through, leave your name, the patient’s name and your number. The team will call back as soon as possible.
