NHS England has announced that the first phase of the introduction of Martha’s Rule will be implemented in the NHS from April 2024. Once fully implemented this will give patients, families, carers and staff, round-the-clock access to an urgent review from a separate care team if they are worried about a person’s condition.

Martha Mills died in 2021 after developing sepsis in hospital where she had been admitted with a pancreatic injury after falling off her bike. Martha’s family’s concerns about her deteriorating condition were not responded to promptly and in 2023 a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier.

In response to this and other cases related to the management of deterioration, the Secretary of State for Health and Social Care and NHS England committed to implement ‘Martha’s Rule’ to ensure the vitally important concerns of the patient and those who know the patient best are listened to and acted upon.

The implementation of Martha’s Rule in the NHS will take a phased approach beginning with at least 100 adult and paediatric acute provider sites who already offer a 24/7 critical care outreach capability. We will ask for expressions of interest to be part of the first phase of the programme (further details will be sent to providers shortly).

The focused approach at the initial provider sites will inform the development of wider national policy proposals for Martha’s Rule that can be expanded in a phased way across the NHS from 2025/26. We will also identify ways to roll out an adapted Martha’s Rule model across other settings including community and mental health hospitals where the processes may not apply in the same way.

Find out more on our Martha’s Rule webpage https://www.england.nhs.uk/patient-safety/marthas-rule/