You may have heard of Martha’s Rule which is a major patient-safety initiative designed to give patients and their families a route to seek an urgent review of their deteriorating condition if it is concerned they are not being responded to fully.
It was rolled out by the NHS earlier this year as a pilot scheme for hospitals and is to be in place in 143 hospitals by March 2025. Whilst Coventry Hospital is one of the named participating hospitals, George Eliot in Nuneaton is not, nor is Warwick or Stratford Hospitals, which is of concern.
Martha’s Rule is named after Martha Mills who died from sepsis aged 13 in 2021, at Kings College Hospital in London, due to a failure to properly recognise and treat her deteriorating condition despite her family raising concerns about their daughter’s health.
What is Martha's Rule?
Martha’s Rule is a 3-part promotion to ensure patients and their families have a consistent and understandable way to seek review of treatment and this is achieved by:
1. An escalation process available day and night for patients/families to contact a critical care outreach team who can swiftly access their case and escalate care if necessary
2. Any healthcare staff will have access to the same procedure if they have concerns about a patient’s care
3. Clinicians at participating hospitals will formally record daily insights and information about the patient’s health directly from them or their family to ensure any concerns raised about behaviour or condition noticed are considered by staff.
In essence, if there is any concern about a patient’s deterioration which the patient/family or staff are worried about, they can ask for a review of that care.
This is based on the findings of the inquest for Martha in which the coroner concluded that if Martha’s family’s concerns about her deteriorating condition had bee heeded, she probably would have survived as she would have been reviewed and moved to Intensive Care sooner.
Is Martha’s Rule Making a Difference in Healthcare?
The answer is a resounding ‘yes’. Early feedback from its implementation was reported by the NHS to have found 1 in 8 calls has led to potentially lifesaving changes in treatment.
It was reported that in September and October 2024 alone, 50% of calls led to a critical care review resulting in a change of treatment whilst others were transferred into intensive care.
It is reported by the Institute of Global Health Innovation (2023) that there were 15,000 preventable deaths in the UK and calls are being made for all hospitals to sign up to the initiative, as the indicators are these figures could be substantially reduced. The NHS’s own medical director, Sir Stephen Powis said Martha’s Rule was starting to have a “transformative effect” on patient safety.
Monitoring will continue and NHS England has said further expansion of the scheme is to be dependent upon both an analysis of the scheme’s efficacy and, as ever, government funding.
It would seem clear from the very early findings produced by Martha’s Rule that a second opinion is welcomed by all. It gives the patient and their families a voice so that they can raise their concerns, knowing they will be listened to, and this is powerful. Even if the care remains the same, for all to feel they helped and did all they could, is critical. This should, in time, also potentially see a reduction in claims against the NHS which also must be welcomed.
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