Martha’s Rule Expands to All English A&E Departments

The NHS has announced the nationwide expansion of Martha’s Rule to all emergency departments in England, aiming to empower patients, families, and staff to request urgent clinical reviews when they believe care is insufficient. The rollout follows a successful eight-month pilot across seven trusts and builds on the rule’s existing implementation on inpatient wards.

Martha’s Rule is named after Martha Mills, a 13-year-old who died from sepsis at King’s College Hospital in London in 2021. A coroner later ruled that she would likely have survived had she been transferred to intensive care and treated sooner. Her parents, Merope and Paul, campaigned to change hospital culture after their daughter’s concerns about her deteriorating condition were not adequately addressed.

Under the new policy, individuals can dial a dedicated phone number to trigger an urgent review if a patient’s condition is worsening and there is a perception that their concerns are being ignored. Hospital staff are also authorized to request a review from a different team if they feel appropriate actions are not being taken.

During the pilot phase, 69 calls were made to the dedicated lines. In several instances, the reviews led to immediate surgery or transfers to intensive care. Professor Aidan Fowler, the national director of patient safety at NHS England, described the expansion as a “critical new lifeline” for improving care and saving lives.

“Early testing has shown that Martha’s Rule can work well in busy A&Es and builds on the evidence from our adult and children’s wards, where thousands of calls have been made to date, with many leading to changes in treatment and potentially life-saving interventions,” Professor Fowler said.

Health minister Baroness Merron stated that the initiative is part of broader efforts to prioritize patient safety within the NHS. The full rollout across all A&E departments is expected to be completed by March 2028.

Patients and families can verify if the rule is available at their local hospital by checking the NHS trust’s website or asking staff. Meanwhile, Scotland has begun implementing Martha’s Rule, Northern Ireland is considering it, and Wales already operates a similar scheme known as Call4Concern.