A MAJOR rule change to allow patients a right to second medical opinion to be tested and rolled out in 143 hospitals.
Named after teenage Martha Mills, who died of sepsis despite her parents’ pleas that she wasn’t receiving the necessary care, the rule will see give patients and their families access to a rapid review if they are worried about their condition.
NHS England pledged to introduce ‘Martha’s Rule’ to at least 100 hospitals in February.
But it announced today that 143 sites will roll out the rule change by March 2025 – surpassing the initial target – following “significant interest” from hospitals across the country.
The purpose of Martha’s Rule is to provide “a consistent and understandable way for patients and families to seek an urgent review if their or their loved one’s condition deteriorates and they are concerned this is not being responded to”, NHSE said.
It’s now working with Martha’s parents to develop materials to advertise and explain the initiative in hospitals across the country, so patients, their families and staff know when to call for a second opinion.
Martha Mills, 13 , died from sepsis in 2021 after medics at King’s College Hospital, London, failed to boost her intensive care despite her parents raising concerns about her rapidly deteriorating condition.
Her parents Merope Mills and Paul Laity said: “We are pleased that the roll-out of Martha’s Rule is off to a flying start and that the need for it has been so widely recognised.
“It will save lives and encourage better, more open, communication on hospital wards, so that patients feel they are listened to, and partners in their healthcare.”
NHSE was initially aiming to implement the rule change in at least 100 hospitals.
But “significant interest from frontline clinicians” had lead to the first phase of the programme being expanded.
By March 2025, patients and their families will be able to request an urgent review into their or their loved one’s care in 143 locations across the country.
Each hospital will evaluate whether the system works over the course of this year.
Martha’s Rule could then be further expanded across all acute hospitals in England, subject to future government funding.
The rule will be made up of three components so that concerns about deterioration can be swiftly responded to.
Firstly, an escalation process will be available 24/7 at all the 143 sites.
This will be advertised throughout the hospitals on posters and leaflets, enabling patients and families to contact a critical care outreach team that can swiftly assess a case and escalate care if necessary.
Secondly, NHS staff will also have access to this same process if they have concerns about a patient’s condition.
Finally, clinicians at participating hospitals will also be obligated to formally record insights and information about a patient’s health provided by their families daily.
This will ensure that any concerning changes in behaviour or condition noticed by the people who know the patient best are considered by staff, NHSE said.
Martha’s parents Merope and Paul campaigned extensively for a single system that allows patients or their families to trigger an urgent clinical review from a different team in the hospital if the patient’s condition is rapidly worsening and they feel they are not getting the care they need.
They were supported by the cross-party think tank Demos.
Their campaigning saw widespread support from hospitals and clinicians.
Professor Sir Stephen Powis, NHS national medical director, said: “Rolling out Martha’s Rule to over 143 NHS sites in this first phase will represent one of the most important changes to patient care in recent years, and we are pleased to have seen such interest from hospitals right across the country, all thanks to the moving and dedicated campaigning by Martha’ parents, Merope and Paul.
“That is why today is such an important milestone, with the NHS outlining the 143 sites where this major patient safety initiative will be rolled out later this year, allowing staff, patients and families to immediately raise concerns and bring about an escalation in care in an easily recognisable and fast way.
“The inclusion of daily insights from families about their loved ones’ condition within patient records is also a really significant step and will help staff identify changes and deterioration using insights from those who know the patient best.
“While thankfully the need for escalation of care will hopefully only be needed in a limited number of cases, this three-step safety net has the opportunity to truly transform patient care and safety.”
SEPSIS is a life-threatening reaction to an infection that happens when your immune system overreacts and starts to damage your body's own tissues and organs.
Symptoms of sepsis in an adult include:
Symptoms in a child include:
They may not have all these symptoms.
If you think you or someone else has symptoms of sepsis, call 999 or go to A&E.
Source: NHS
NHS national patient safety director and senior responsible officer for Martha’s Rule, Dr Aidan Fowler, added: “Working closely with Martha’s parents and colleagues across the NHS over the last few months on this rollout, I am in no doubt this programme will deliver clear change.
“It has been so encouraging to see how many hospitals have shown interest in being part of delivering these all-important patient safety measures this year.
He said the new processes brought about by Martha’s rule “can help us better identify and manage deterioration as part of wider work, which is a key priority for us and will no doubt lead to improvements in the care patients receive”.
The parents of young rugby star Maddy Lawrence recently expressed their support of Martha’s Rule, after their 20-year-old daughter died in hospital from sepsis.
Maddy’s “screams of pain” weren’t listened to by medics until it was too late and she was branded a “difficult patient”.
NHS provided the full list of hospitals rolling out the rule change: