Advising with empathy and experience

"Martha's Rule" to be introduced in NHS hospitals from April


Hospitals in England will be offered funding from next month (April 2024) to introduce "Martha's rule", the NHS has announced.

The government has backed plans to introduce a system giving seriously ill patients easy access to a second opinion if their condition worsens.

About two-thirds of hospitals, at least 100, will initially be able to apply to participate in the scheme which follows a campaign by the parents of Martha Mills, 13, who died of sepsis because her symptoms were missed.

Martha's mother, Merope, told BBC R4's Today programme she believed the new system would save lives and mean her daughter had not died in vain.

Merope Mills previously said she and her husband, Paul Laity, had been ignored when they had raised concerns about Martha's care and asked for her to be transferred to intensive care.

Under the new scheme, participating hospitals will receive government funding for posters and leaflets informing patients and their families that they can directly ask a team of critical-care medics for a "rapid review" of treatment, NHS England said.

The reviews will be carried out by a senior doctor or nurse from elsewhere in the building, who specialises in the care of patients who are deteriorating. Medics will also formally record families' observations of a patient's condition or behaviour. 

The British Medical Association (BMA), which represents doctors, welcomed the scheme, but said it would need to be carefully monitored before being introduced throughout the NHS.

Chairman of the BMA consultants’ committee, Dr Vishal Sharma, said: "For this to result in improvements for patients, it is essential that the current workforce crisis is addressed so that critical care outreach teams have the necessary staff they need to deliver this initiative."

Merope Mills, who believes that Martha's death was preventable, and that the new system would have saved her life, said: "Sometimes, doctors are incredibly overstretched, and they cannot always spot the same changes in a patient that family and patients themselves can."

Martha was admitted to King's College Hospital, south London, in 2021, after injuring her pancreas slipping on to the handlebars of her bike while cycling. She later developed sepsis but, with better care, could have survived, an inquest found. The hospital apologised for its mistakes.

Ms Mills added: "We told three different consultants that we were worried about her and we were just told she would be fine and this was a normal infection she had. And when I had my doubts, still, I had nowhere to go. There was no ripcord to pull. I just had to trust the doctors."

Patients already have the right to a second opinion if their condition deteriorates but trusts currently operate different systems.

Challenging doctors could be "difficult", Ms Mills said. And without the new scheme, many patients and their families would not know how.

NHS England chief executive, Amanda Pritchard, said: "NHS teams have been piloting ways to better identify and respond in these cases, during the last year, and the rollout of a national programme to give patients and families 24-7 access to a rapid clinical review will now help ensure that those experiencing acute deterioration can be identified and treated much more quickly. 

"While the need for escalation will hopefully be needed only in a small number of cases, I have no doubt that the introduction of Martha's rule has the potential to save many lives in the future."