NHS England has announced the first 143 hospitals that will trial the Martha’s Rule, which enables patients with worsening conditions to demand an urgent second opinion.  

In February 2024, NHS said that this patient safety initiative would be rolled out across at least 100 sites.  

The roll-out is said to have been expanded to more sites due to high interest from clinicians.  

This programme’s first phase will be implemented across 143 hospital locations, including Southend Hospital, Bedford Hospital, University College Hospital, and Queen Elizabeth Hospital, among other sites, by March 2025. 

The results from this initial pilot will help in shaping proposals for a broader rollout to all acute hospitals in the UK, depending on future government funding.  

Martha’s Rule is named in memory of Martha Mills, who died of sepsis at King’s College Hospital in 2021 after her condition was not escalated to intensive care in time. 

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The latest initiative aims to offer a clear method for escalating concerns about a patient’s deteriorating condition.  

NHS England is collaborating with Martha’s parents, Merope and Paul Mills, to develop materials that will introduce and explain Martha’s Rule in hospitals nationwide, ensuring that the process is easily recognisable for patients, staff, and families. 

Martha’s Rule comprises three key elements, including a round-the-clock escalation process that will be promoted across 143 hospitals, allowing families to reach a critical care outreach team for immediate assessment and potential escalation of care.  

Secondly, NHS staff will have access to this process for raising their concerns regarding the patient’s condition.  

Lastly, clinicians will formally document daily input from families about the patient’s condition, ensuring that insights from those closest to the patient are considered. 

NHS national patient safety director and Martha’s Rule senior responsible officer Dr Aidan Fowler said: “Working closely with Martha’s parents and colleagues across NHS over the last few months on this rollout, I am in no doubt this programme will deliver clear change and it has been so encouraging to see how many hospitals have shown interest in being part of delivering these all-important patient safety measures this year.”