Martha’s Rule: How a Tragic Loss Led to Life-Saving Changes in NHS Hospitals
A Transformative Patient Safety Initiative
The story of Martha’s Rule began with the tragic death of Martha Mills in 2021, who died from sepsis while being treated at King’s College Hospital after a bike accident. During her stay, her family’s concerns about her deteriorating condition went unheeded, and a coroner later ruled that Martha would likely have survived if she had been moved to intensive care earlier.
Current Implementation and Impact
As of May 2024, Martha’s Rule has been implemented across 143 pilot sites throughout England, with plans to expand to all providers, including community and mental health facilities in the coming years, subject to government funding.
Early data has shown remarkable results: in September and October alone, there were 573 calls made to escalate concerns about deteriorating patients. Of these, 286 required clinical review, with 57 cases leading to immediate changes in patient care, such as the administration of life-saving antibiotics, oxygen, or other crucial treatments.
How Martha’s Rule Works
The initiative consists of three key components:
1. A 24/7 escalation process available at all sites, clearly advertised throughout hospitals, allowing patients and families to contact a critical care outreach team for swift assessment;
2. Access to the same process for NHS staff who have concerns about a patient’s condition;
3. A formal daily recording system where clinicians document insights about a patient’s health directly from their families, ensuring that changes noticed by those who know the patient best are considered.
Future Prospects
The NHS is actively working with providers interested in testing the system in various settings. The intention is to expand Martha’s Rule to all providers, including community and mental health facilities, in the coming years, pending government funding.
The initiative is seen as an empowering tool for patients and their families, providing a crucial opportunity for their voices to be heard. With thousands of avoidable deaths occurring in the NHS each year, Martha’s Rule represents a significant step forward in preventing such tragedies.
