The rule is named after Martha Mills, who passed away in 2021
The NHS has issued a warning to parents, urging them to remember one ‘rule’. In a post on X, formerly Twitter, it reminds people of Martha’s Rule – and who she was.
This life-saving and crucial rule ‘helps detect deterioration in hospital patients early and it applies to every patient’. In a message to parents specifically, it urges them to say something.
It continued: “If your child is ever in hospital, trust your instincts and speak up if you notice any changes that worry you.”
So what else do you need to know, here is what the NHS England writes.
What is Martha’s Rule?
The NHS explains: “Martha’s Rule is a patient safety initiative to support the early detection of deterioration by ensuring the concerns of patients, families, carers and staff are listened to and acted upon.
“It has been developed in response to the death of Martha Mills and other cases related to the management of deterioration. Central to Martha’s Rule is the right for patients, families and carers to request a rapid review if they are worried that their or their loved one’s condition is getting worse and their concerns are not being responded to.”
It adds: “Martha’s Rule recognises that those who know the patient best may be the first to notice changes that could be an early sign of deterioration, and the importance of listening to and acting on the concerns of patients, families, and carers. It is being implemented in both adult and children’s inpatient settings in England.”
Who was Martha?
Martha Mills passed away in 2021 after developing sepsis while in hospital, where she had been admitted with a pancreatic injury following a cycling accident. Despite her family’s repeated concerns about her worsening condition, their warnings “were not responded to”.
In 2023, a coroner concluded that Martha, who was 13 years old, would likely have survived if she had been transferred to intensive care sooner. In response to this and similar cases involving the handling of clinical deterioration, the Secretary of State for Health and Social Care at the time, along with NHS England, committed to introducing ‘Martha’s Rule’ across the NHS.
The three core components of Martha’s Rule mean:
- Patients will be asked, at least daily, about how they are feeling, and if they are getting better or worse, and this information will be acted on in a structured way.
- All staff will be able, at any time, to ask for a review from a different team if they are concerned that a patient is deteriorating, and they are not being responded to.
- This escalation route will also always be available to patients themselves, their families and carers and advertised across the hospital.
Signs to watch out for
The NHS urges parents to look out for these signs:
- Your child has a high temperature – sweating, shivering or feeling hotter or colder than usual when you touch them
- Your child has a different cry to normal
- Your child has any changes to their skin, for example, they are pale or have a rash (this may be harder to see on black or brown skin) or sores or blisters
- Your child is unusually sleepy or hard to wake
- Your child is irritable or restless
- Your child is not interested in feeding, drinking or eating
- Your child is breathing faster than normal, grunting with each breath or wheezing
- Your child is peeing much less or has blood in their poo
- Your child has other signs or symptoms that are worrying you
Do this if you are worried
- Speak to the team caring for your child
- If you are still worried and feel your concerns are not being addressed, call for a rapid review
Rapid reviews are available 24 hours a day, 7 days a week, by calling your hospital’s dedicated number for this service. A rapid review means “your request will go to a different team in the hospital who specialise in the care of very ill patients. They will work with you and your child’s care team to arrange any treatment needed or further review.”