The NHS has announced plans to expand “Martha’s Rule” to every Accident & Emergency (A&E) department in England. This initiative enables patients, their relatives, and healthcare staff to request an urgent review of care if there are concerns about a patient’s deterioration.
‘Martha’s Rule’ originated following the tragic death of 13-year-old Martha Mills at King’s College Hospital in London in 2021, after developing sepsis. Her family felt their concerns had been overlooked, prompting them to advocate for a cultural change in clinical responsiveness.
Under the new guideline, individuals in A&E units will have access to a dedicated phone line to initiate immediate reviews if they believe a patient’s condition is worsening and not being adequately addressed. This service will also be available in A&E waiting rooms.
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NHS England described the move as providing “a critical new lifeline” to enhance patient care and save lives.
Professor Aidan Fowler, NHS England’s Director of Patient Safety, said: “Emergency departments care for some of the most vulnerable patients, making rapid identification and review of clinical deterioration crucial. Martha’s Rule is already transforming acute care safety. By extending it to A&E, we empower patients, families, and staff to raise urgent concerns, potentially saving more lives.
“Initial trials have demonstrated the rule’s effectiveness in busy A&E settings, complementing results seen on adult and children’s wards where thousands of calls have resulted in treatment adjustments and potentially life-saving interventions.”
Matthew Hopkins, Acute and Ambulance Director at the NHS Alliance, welcomed the initiative, stating: “Following its pilot in seven trusts, the rollout to all hospital A&E departments and waiting rooms reinforces the NHS’s commitment to patient safety. It ensures vulnerable patients, their families, and staff can have their voices heard and concerns addressed promptly.”
Health Minister Gillian Merron added: “Martha’s Rule ensures patients and their loved ones are listened to when raising concerns about care. Its extension to A&E departments provides an additional channel to act swiftly when patients' conditions worsen. This is a key part of our ongoing efforts to prioritise patient safety throughout the NHS.”