Martha’s is a rule named in memory of Martha Mills, a 13 year old, who tragically died in 2021 after developing sepsis in hospital, following a bike accident. Sepsis is a major cause of avoidable death, with at least 245,000 cases in the UK every year. Despite her family’s repeated concerns about her deteriorating health, there was a delay in staff responding to her condition. In 2023, a coroner concluded that Martha would likely have survived had she been transferred to intensive care sooner. The introduction of Martha’s Rule aims to enhance patient safety, responsiveness and communication, ensuring that critical concerns are not overlooked and timely action is taken. It is a significant milestone in empowering patients, families and caregivers, and ensuring their concerns are acknowledged.
- Shining a spotlight on sepsis
- Sepsis: investment in training vital
- Persistent understaffing of NHS a serious risk to patient safety
There are three proposed components to Martha’s Rule. The Rule mandates that all staff in NHS trusts have 24/7 access to a rapid review from a critical care outreach team, which they can contact if they have concerns about a patient. Additionally, all patients, their families, carers and advocates must have the same access to this service, if there are concerns about the patient’s condition.
The rollout of Martha’s Rule is being phased in. It will commence in at least 100 adult and paediatric acute provider sites that already offer 24 hour, seven day a week critical care outreach capabilities beginning April 2024 The aim is to extend this system across all NHS sites in England by 2025/26. The concept could well be extended to include settings such as GP practices, community hospitals and mental health trusts at a later date to ensure that the concerns of patients and those who are closest to them are promptly heard and acted upon. Enhancing the identification, rand handling of acute deterioration is a paramount patient safety objective for the NHS and all nurses are key players in this.There remains much work to be done in the implementation of Martha’s Rule across the whole of the NHS.
All organisations must be committed to the principles of this important endeavour along with support from NHS England that will include additional funding for project resources as well as access to specialist implementation support and expertise from the Health Innovation Network’s Patient Safety Collaboratives (the innovation arm of the NHS). It is important that this scheme is robustly evaluated as it is rolled out and implemented, embedding the principles of patient partnership across the health and care system, transforming outcomes and experiences for the better.
Patients already have the right to a second opinion if their condition deteriorates but, trusts currently operate different systems. Martha’s Rule has the real potential to save many lives in the future.