The Martha’s Rule scheme, designed to address the concerns of patients and families when care is deteriorating, has shown promising results. NHS England has revealed that nearly one out of every eight phone calls made under this initiative has led to a potentially life-saving change in treatment.
The scheme allows patients and their families to call a hospital’s dedicated number if they feel their concerns are being ignored. By doing so, they can request an urgent review from a critical-care outreach team to assess the patient’s condition and alter their treatment plan if necessary.
Why Was Martha's Rule Created?
Martha’s Rule was born from the tragic loss of 13-year-old Martha Mills, who died from sepsis in 2021. Her mother, Merope Mills, began campaigning for the Rule after an inquest revealed that a change in her daughter’s care plan might have saved her life.
Merope responded emotionally to the scheme’s early success: “I’m excited by the early data on its rollout in 143 NHS hospitals across England. It’s heartening to see change taking place.”
What Do the Early Results of the Scheme Show?
The impact of Martha’s Rule scheme is already evident. NHS England recorded 573 calls to the Martha’s Rule line in September and October. Of those, 286 calls (50%) resulted in a critical-care review. In 57 cases, the patient’s treatment was altered, such as the introduction of antibiotics, oxygen, or other medications. Additionally, 14 patients were transferred to intensive care for more urgent treatment.
Martha’s own story underscores the importance of such a scheme. She was admitted to King’s College Hospital in South London after injuring her pancreas in a cycling accident. Unfortunately, she developed a severe infection that led to sepsis, which ultimately took her life. Merope Mills shared the profound grief of losing a loved one in such a preventable way: “Losing a loved one in a preventable way compounds your grief and your devastation. But if nobody learns from it, nothing changes.”
What Concerns Were Raised About Martha's Rule?
When Martha’s Rule was first introduced in April, there was skepticism about whether it would work as intended. Critics voiced concerns that patients would misuse the system, complaining about trivial matters such as food or requests for cups of tea.
Ms. Mills reflected on those early doubts: “There were skeptics at the scheme’s launch. Some people said, ‘If you give patients this kind of power, they’ll call for the wrong reasons.’ They thought it would lead to complaints about non-urgent issues. But we now have the first clear evidence that this is not the case.”
She firmly believes that expanding Martha’s Rule could save lives and foster cultural change within the NHS: “If we implement Martha’s Rule nationally, we can confidently say that it would greatly improve care, change the culture, and save lives.”
How Can Martha's Rule Be Expanded Nationwide?
Ms. Mills is now calling for the scheme to be extended to all NHS hospitals across the UK, with consistent branding and easily recognizable posters and leaflets for patients to understand the initiative. She wants Martha’s Rule to be as well-known as emergency numbers like 999 and 111.
“I’d like it to be simple across the country, and for patients to understand it in the way that they understand 999 and 111,” she said.
How Could Martha's Rule Help Reduce Preventable Deaths?
Mills highlighted an alarming statistic from the Institute of Global Health Innovation: More than 15,000 preventable deaths occurred in the UK last year. Martha’s Rule could contribute to reducing this number by empowering families and patients to speak up when they feel treatment is insufficient.
“It could play a part in getting that number down,” she said.
What Does the Future Hold for Martha's Rule?
NHS England has expressed a commitment to developing the scheme further. According to their plans, 2025 and 2026 will see more widespread adoption of Martha’s Rule, with further adaptations made to suit the needs of hospitals nationwide.
The NHS in Wales is currently piloting a similar scheme, and Northern Ireland is also considering it. In Scotland, legislation passed in 2019 already gives NHS patients the right to request a second opinion.
What Impact Does Martha's Rule Have on Patient Safety?
The NHS National Medical Director has praised the initial results, noting that Martha’s Rule transforms patient safety.
“The early evidence suggests that Martha’s Rule is starting to have a significant impact,” they said.
How Will Martha's Rule Be Expanded?
The expansion of Martha’s Rule across all acute hospitals in the UK is contingent on future government funding. NHS England has stated that the ongoing pilot’s success will inform the national rollout’s evaluation process.
Ms. Mills hopes the evidence gathered will convince authorities to invest in a nationwide system that can ultimately save lives and improve patient care. “I believe this will make a huge difference,” she concluded.
