England’s National Health Service has announced plans to expand Martha’s rule to all accident and emergency departments throughout the country. The expansion represents a significant broadening of a patient safety initiative that previously operated on inpatient wards and maternity units.
Martha’s rule enables patients, their families, and healthcare workers to request rapid reviews of patient care and recommend treatment changes. The system is named after Martha Mills, a 13-year-old who died from sepsis in 2021 following a bicycle accident. Medical authorities determined she likely would have survived had she been transferred to intensive care at an appropriate time. Her parents, Merope Mills and Paul Laity, subsequently launched a campaign that led to the creation of the formal system.
Since the initiative’s introduction in England in 2024, helplines have received more than 10,000 calls over a 16-month period, with officials reporting that 446 lives were potentially saved. Callers have prompted various interventions including intensive care transfers, medication administration, and other clinical modifications. In June of this year, the program expanded to maternity and neonatal units, allowing parents and expectant mothers to seek second opinions regarding care.
A pilot program involving seven healthcare trusts tested the application of Martha’s rule in emergency departments over an eight-month period. During this testing phase, 69 calls were made, resulting in urgent surgeries and intensive care transfers for some patients. NHS England has announced a phased rollout beginning this month, with completion targeted for March 2028. The most recent data from July 2026 showed 1,678 calls, representing the highest monthly total since the program’s launch.
NHS leadership and government health officials have expressed support for the expansion, characterizing it as essential for protecting vulnerable patients in busy emergency settings and ensuring that safety concerns are addressed promptly.
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