The NHS in England has commenced the implementation of Martha's Rule across hospital sites, a patient safety initiative, designed to address urgent health concerns.

The rule allows patients and families to request an immediate review if they believe a patient's condition is worsening and that the response from healthcare providers is inadequate.

NHS National Medical director Stephen Powis said: “The introduction of Martha’s Rule represents one of the most important changes to patient care in recent years, and we are really encouraged to see the impact it is already having for patients in this first phase.”

Named after Martha Mills, who tragically died from sepsis at 13 years after her condition was not escalated to intensive care, Martha's Rule comprises three key components.

These include a 24/7 accessible escalation process, visible information on how to contact a critical care outreach team, and the formal recording of daily insights from patients' families by clinicians.

The NHS revealed in May 2024 that 143 hospital sites will test and launch the initiative in its first year, surpassing the initial target of 100 sites.

This expansion was driven by considerable interest from frontline clinicians.

By March 2025, all 143 locations are expected to have Martha's Rule in place.

Early data from 136 of the participating sites indicates that 87 have already implemented the escalation process for patients and families, while 92 sites have partially or fully implemented it for staff.

This year, the effectiveness of Martha's Rule will be evaluated, with the potential for further expansion across all acute hospitals, contingent on future funding from the government.

Health and Social Care Secretary Wes Streeting said: “The roll-out of Martha’s Rule is already playing a role in building a safer NHS by putting patients and their families at the heart of discussions about their healthcare, and early indications are that it could have a transformative impact.”