Since its introduction in 2024, Martha’s Rule has proven to be a beacon of hope for over 500 patients, providing them with potentially life-saving care through the right to seek a second opinion regarding their health. This innovative patient safety mechanism allows hospital patients, their families, and NHS staff to request a “rapid review” of care when there are concerns about a patient’s condition or treatment.
Between September 2024 and February 2026, a remarkable 524 adults and children were transferred to intensive care units, high-dependency units, or specialist wards following concerns raised by patients, relatives, or NHS personnel. Health Secretary Wes Streeting has highlighted these figures as evidence of the rule’s significant impact on saving lives, marking it as a monumental advancement in patient safety.
The rule is named in honour of Martha Mills, who tragically passed away at the age of 13 in 2021 after her family’s concerns regarding her deteriorating health were overlooked by staff at King’s College Hospital in London. Following her untimely death, her parents, Merope Mills and Paul Laity, passionately campaigned for the establishment of a protocol that would allow for an independent review of a patient’s care by a different medical team. This initiative aims to ensure that patients receive the attention they need, particularly in critical situations.
An inquest into Martha’s death revealed that she likely would have survived had her sepsis been identified sooner. The coroner’s findings underscored the importance of timely intervention and the need for improved communication within hospital settings. The latest data from NHS England indicates that during the 18-month period, there were 12,301 calls made to the helplines associated with Martha’s Rule. Of these, approximately one in three calls, 4,047 in total, successfully identified patients whose health was deteriorating. Notably, three-quarters of these calls were initiated by patients or their carers, demonstrating the crucial role of family members in advocating for patient safety.
Merope Mills and Paul Laity expressed their encouragement that 1,000 clinically trained staff members had sought reviews under the new protocol. They noted that this reflects ongoing issues within hospital culture, such as hierarchy and poor communication, which can hinder patient care. “These factors are integral to understanding why Martha lost her life,” they stated. They highlighted a specific instance where a nurse recognised the urgent need for Martha to be moved to intensive care, yet the decision ultimately rested with the ward consultant, who was not present in the hospital at the time and made critical errors in judgement. They argued that had Martha’s Rule been in place, the nurse could have easily called the helpline to escalate the situation.
An interim review released recently revealed that while 32% of the public are aware of Martha’s Rule, thanks to hospital promotions via posters and other outreach, those with higher education were four times more likely to have heard of it compared to the general population. Martha’s parents are keen to foster a broader public conversation about healthcare, one that delves into cultural issues and transcends the immediate challenges posed by resource constraints.
Paul Whiteing, chief executive of the patient safety charity Action Against Medical Accidents, commented on the prevailing culture of defensiveness that often greets patients who raise concerns about their treatment. He emphasised the importance of expanding the use of Martha’s Rule to challenge this culture effectively. “If this rule is indeed changing the landscape of patient care, its implementation must be broadened as soon as possible,” he said.
Wes Streeting acknowledged the profound impact of Martha’s parents’ advocacy, stating, “They have turned unimaginable grief into a force for change within our NHS. Merope and Paul have fought for a practical change that places patients and families at the centre of care, an initiative that is already saving lives.” He commended their extraordinary courage and reiterated that the NHS owes them a significant debt of gratitude.
Streeting also noted that the NHS is committed to evolving its culture to prioritise patient safety. “While change is never easy, Martha’s Rule is a testament to what can be achieved,” he concluded.
In summary, Martha’s Rule stands as a pivotal advancement in patient safety, empowering individuals and families to advocate for their health and wellbeing. As awareness of the rule grows and its implementation expands, it holds the potential to transform hospital care and ensure that the voices of patients and their families are heard and respected. The legacy of Martha Mills lives on through this vital initiative, reminding us all of the importance of vigilance, communication, and compassion in healthcare.
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