Martha’s rule, a key patient safety initiative, which lets NHS patients and families request an urgent review of their care is now fully implemented across all 210 acute hospitals in England.

POhWER’s Deputy CEO, Elyzabeth Hawkes, welcomed the change, saying:

Martha’s Rule is named in memory of 13-year-old Martha Mills, who tragically died in 2021 after developing sepsis in hospital. Despite her parents raising concerns about her worsening condition, her care team did not act, and a coroner later concluded that Martha would probably have survived if she had been moved to intensive care sooner.

In response, and to strengthen how the NHS manages deteriorating patients, the then Secretary of State for Health and Social Care and NHS England committed to implement ‘Martha’s Rule’ to ensure the voices and concerns of patients and those who know them best are listened to and acted upon.

• First, speak to the team caring for you or your loved one if you are worried
• If, after speaking to the care team, you remain worried and feel your concerns are not being addressed, call the number on the Martha’s rule poster or leaflet for a rapid review.
• Your call will go to a different team in the hospital, who specialise in the care of critically ill patients. They will work with you and your care team to arrange any treatment needed or further review.
  
  

Martha’s Rule is a powerful safeguard. It empowers patients, families, carers, and staff to call for an independent, urgent review from a different team of experts within the same hospital if they are worried about a patient’s care or condition.

Between September 2024 and June 2025, there were 4,906 calls made to Martha’s Rule helplines to escalate concerns about care – leading to 241 potentially life-saving interventions being triggered.

Some of the calls have led to transfers to HDU and ICU, and changes in the management of care, highlighting the importance of early intervention and patient and family/carer advocacy.

Martha’s Rule allows hospital inpatients and their families to seek a rapid review if their condition, or the condition of a family member or friend, is deteriorating.

A second opinion is an already established process where patients, families or carers can ask to see another consultant to discuss any diagnosis or treatment.

(It is important that Martha’s Rule is not referred to as a method to receive a second opinion.)

1. Be aware of how Martha’s Rule works and the positive changes it’s driving
2. Share the message with colleagues and clients, so they know there is now a clear and supported route to escalate concerns if they feel unheard.

Find out more about Martha's Rule

Find more resources about Martha's Rule