The National Health Service announced plans to implement Martha’s Rule across all accident and emergency departments in England, with the nationwide expansion expected to be complete by March 2028. The initiative follows a trial conducted at seven trusts and builds on successful implementation in inpatient wards across the country.
Martha’s Rule enables patients, relatives, and staff members to contact a dedicated phone line to initiate an expedited clinical review if they believe a patient’s health is declining and their concerns are not being adequately addressed. When such a call is made, an appropriate response is provided—potentially involving a senior nurse or a member of the critical care outreach team to assess the case. Staff members also have the option to request a review from a different clinical team if they believe proper measures are not being taken.
The rule is named after Martha Mills, a 13-year-old who died in 2021 following complications from sepsis after a cycling accident. A coroner determined that she would likely have survived had she been transferred to intensive care earlier and received appropriate treatment. Her parents created the initiative to foster cultural change within healthcare settings regarding how patient concerns are addressed.
During an eight-month pilot at seven emergency departments, 69 calls were made to Martha’s Rule phone lines, with some resulting in immediate surgery or intensive care transfers. Data from inpatient wards, where Martha’s Rule has been operating more broadly, revealed nearly 20,000 calls, with approximately three-quarters coming from family members. Officials noted that many calls led to treatment modifications and potentially life-saving interventions.
Scotland has begun implementing Martha’s Rule, and Northern Ireland is evaluating its adoption. Wales operates a comparable program called Call4Concern. Health officials stated that the expansion addresses patient safety priorities and represents part of broader efforts to enhance healthcare quality. Supporters, including family members of sepsis victims, have advocated for the program’s expansion, emphasizing its potential to save lives and give patients and families a voice in their care.
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