Patients have been moved to intensive care or received potentially life-saving treatment such as oxygen as a direct result of hospitals adopting Martha’s rule, NHS data shows.
Doctors and nurses have changed how they care for dozens of very sick patients since its introduction in many parts of the NHS in England during the course of 2024.
Martha’s rule, named after Martha Mills, who died in 2021 aged 13, gives patients and their loved ones the right to request an urgent review of the person in hospital’s treatment. That triggers their care being looked at urgently by a team of specialists, who offer a second opinion.
Prof Sir Stephen Powis, NHS England’s national medical director, 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.”
Martha’s mother, Merope, a senior editor at the Guardian, disclosed the data showing the improvements to patient care the second opinion has had since its rollout in April, during an interview on the BBC Radio 4 Today programme on Tuesday morning.
The new patient safety procedure has led to 573 calls, across the 143 hospitals using it, in which someone has sought an urgent review. About half (286) have prompted an urgent review by critical care staff. And about one in five of those reviews – 57 cases – has led to the person’s care being escalated, for example by being given potentially life-saving antibiotics or other drugs.
During September and October alone, 14 patients were transferred to intensive care after Martha’s rule was deployed. Martha died after doctors at King’s College hospital in London did not move her to its intensive care unit despite her parents voicing serious concern about her care.
Merope told the Today programme: “It’s clear to me that if we implement Martha’s rule nationally, we can confidently say that it would greatly improve care, change the culture, and save lives.”
She continued: “Any doctors who still have doubts about the value of Martha’s rule, I’d love them to realise a bit of humility and being open to the opinions of the family and patients makes for the best and safest medicine.
“Someone quite senior in the NHS last week admitted to me: ‘I was a sceptic about this, and now I’m a convert.’
“When I see this data, it seems to me it’s making a difference, and it will make a difference in future to I hope hundreds, one would hope thousands, of people’s lives.”
Powis said: “With one in five clinical reviews triggered by Martha’s rule so far leading to potentially life-saving changes in care, this early insight suggests the initiative is starting to have a transformative effect in improving patient safety further.
“We are so grateful to Martha’s parents, Merope and Paul, for their campaigning and continued collaboration to help the NHS save more lives.
“This early data highlights just how essential the Martha’s rule escalation process will be for patients, families and staff, to help ensure those experiencing acute deterioration can be identified and treated at the earliest possible opportunity.”
Patient groups welcomed what they said was a significant improvement to the safety of care.
Rachel Power, the chief executive of the Patients Association, said: “These first statistics from Martha’s rule, with over 500 calls across 143 hospitals, show what happens when healthcare services truly listen to patients and their families. Each call represents someone who felt confident to speak up, and knew where to turn, when they spotted deterioration.
“Patients and families must be equal partners in care decisions – their voices, concerns, and observations are invaluable and can mean the difference between life and death.
“The success of these early numbers shows exactly why Martha’s rule needs to be rolled out across the entire NHS – because when we listen to patients and families and act on their concerns, lives can be saved.”
Paul Whiteing, the chief executive of the patient safety charity Action Against Medical Accidents, said: “This early data … shows that for one in five patients the exercise of their right led to a change in the treatment plan [and] is a reminder that patients and their families must be listened to by medical professionals, as this is a clear way to improve patient safety for everyone.”
