Martha’s Rule, which gives patients and their loved ones the right to a second medical opinion, can “save lives”, Martha Mills’s mother has said.
The first two months of the initiative saw 14 people transferred to intensive care units after patients, their family or NHS staff called for a second opinion.
Other patients have also been moved to high-dependency units, coronary care units and received other care, such as returning to operating theatres.
Merope Mills, whose daughter Martha died with sepsis in 2021, has called for the initiative to be rolled out nationally.
Some 143 hospitals have signed up so far.
The escalation process offers patients and families the power to seek a second opinion if they believe a patient’s condition is deteriorating and they are not being listened to.
An urgent clinical review is then carried out by a different team in the hospital.
One in five of the 573 calls made to raise concerns about a patient’s condition deteriorating in September and October led to a change in the patient’s care, according to NHS England.
This could include giving the patients potentially life-saving antibiotics, oxygen or other treatments.
Around half of the calls required a “clinical review for acute deterioration”, according to NHS England figures.
Family members made the most calls – accounting for 76% – with 15% made by patients themselves.
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
Some 9% of calls were made by NHS staff.
Martha Mills, 13, died from sepsis in 2021 after suffering a pancreatic injury when she fell off her bike.
Ms Mills and her husband Paul Laity sounded the alarm about their daughter’s health a number of times, but their concerns were brushed aside.
A coroner ruled she would most likely have survived if doctors had identified the warning signs of her rapidly deteriorating condition and transferred her to intensive care earlier.
Ms Mills told BBC Radio 4’s Today programme that campaigning for the new system had been “exhausting”.
“Losing a loved one in a preventable way compounds your grief and your devastation,” she said.
“But if nobody learns from it, nothing changes, it makes you feel as if their life meant nothing to the people who let them down.
“So pushing through this change has been exhausting at times but in some level it has helped us both to see that people are prepared to learn from Martha’s death and those mistakes.”
She added: “There were definitely sceptics. There were definitely people who said if you give patients this kind of power, this kind of phone number to call, they’ll call it for the wrong reason – they’ll be complaining about food, they’ll be wanting a cup of tea, they’ll say they have lost something.
“We’ve now had Martha’s Rule trialled in 143 hospitals around the country, and we have the first clear evidence that that is not the case.
“In two months of data that we have, we’ve had over 500 calls to a Martha’s Rule number – that’s not an overwhelming number of calls for that number of hospitals, which is good. It means that the system can cope.
“And as many as half of those calls merited a critical care review by staff.
“Fourteen people went to intensive care as a result of a Martha’s Rule call.”
She said others received antibiotics which may have come too late had the call not been made.
“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,” Ms Mills added.
“I’d really like it to be simple around the country and for patients to understand it in the way that they understand 999 and 111.”
Ms Mills said she was “excited” about the data showing Martha’s Rule is “making a difference”, and “it will make a difference in future to, I hope, hundreds – one would hope, thousands – of people’s lives”.
On seeing posters about the initiative with Martha’s face on, she said: “It’s a lovely thing to come out of a dreadful thing.”
It was announced in February that Martha’s Rule was expected to be rolled out by at least 100 NHS trusts in England from April.
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
NHS England later revealed 143 hospital sites would test the rule, which would be available 24 hours a day and advertised on posters and leaflets throughout hospitals.
Health Secretary Wes Streeting said Martha’s Rule is helping to “build a safer NHS” while NHS England said its introduction had been “one of the important changes to patient care in recent years”.
“I thank Merope Mills and Paul Laity for their tireless campaign for Martha’s Rule. It is just a shame that it took such a heartbreaking tragedy, and the bravery of Martha’s parents to speak out, for this change to be made,” he said.
“The rollout 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.”
Professor Sir Stephen Powis, national medical director for the NHS in England, 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.
“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.
“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.”
Dr Aidan Fowler, senior responsible officer for the programme at NHS England, said: “Thanks to the engagement and hard work of the 143 pilot sites, we are already seeing life-saving interventions from calls made under Martha’s Rule.
“In addition to providing a valuable failsafe to identify deterioration, this is increasing the sensitivity of our own monitoring as families and staff are very sensitive to changes in patients they know well.”
Former health secretary Jeremy Hunt said that Mr Streeting should mandate Martha’s Rule across NHS hospitals in England.
“It’s a bit of a no-brainer,” he told the Today programme.
“But this is only one of very many patient safety issues… One of the reasons there are so many cover-ups in the NHS is that many doctors and nurses just worry that if they say they made a mistake, they’ll get fired.
“What you need is a culture where people are able to say if they think they’ve done the wrong thing, and lessons can be learned.”
The pilot scheme of Martha’s Rule will end in 2025.
An evaluation of the pilot will inform proposals for it to be rolled out to the final 65 hospitals in England not currently participating.
The evaluation could also propose that the scheme is expanded beyond hospitals to other healthcare settings.
– The data released by NHS England relates to 136 of the 143 sites involved in the pilot of the programme.
