Martha's Rule: What it means for you and your loved ones in NHS care? (2024)

Hundreds of NHShospitals will roll out Martha's Rule in a major patient safety shake-up — and MailOnline can reveal the full list of hospitals already signed up to take part.

The new guidance puts in writing for the first time patients' rights to a medical second opinion — described today by NHS boss Professor Sir Stephen Powis as 'one of the most important changes to patient care in recent years.'

It was named after13-year-old Martha Mills who died while under the care ofKing's College Hospital NHS Foundation Trust in south Londonin 2021.

Speaking on the BBC's Today programme Martha's mother, Merope, said the large number of hospitals that had willingly volunteered to take part was 'really encouraging' and showed 'the need for this is widely recognised by doctors.'

The new rules would play a role in 'changing the culture of the NHS' and challenge 'deference' towards doctors that exists in some hospitals, she added.

Martha died of sepsis,a dangerous overreaction by the body's immune system to an infection which causes it to attack healthy tissue,after a pancreatic injury following a fall from her bike.

But 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.

Her death came despiteher parents expressing concern about her deteriorating condition to her medical team on multiple occasions.

In the wake of her death her grieving parents campaigned for Martha's Rule,an established formal right for families to get a second opinion from medics, if they feel their concerns aren't being taken seriously.

Her death came despiteher parents expressing concern about her deteriorating condition to her medical team on multiple occasions.

Ms Mills said: 'It's just as important that Martha's Rule plays a part in changing the culture of the NHS.

'We hope it will do an immense amount of good by improving communication and encouraging doctors just to be more open and to listen to patients more carefully.'

'We also want patients to be able to challenge this culture of deference that we have, this sense that [the] doctor always knows best, because I personally have come to believe that a more equal relationship is a safer relationship.'

Ms Mills hoped the hotline, staffed by a critical care outreach team, would be seen as 'a bit like 999 or 111, within a hospital setting, that you can call if you feel something is going wrong.'

Here, MailOnline explains how patients and their loved ones will be able to access help under Martha's Rule.

A total of 143 NHS hospitals will be taking part in the initial rollout, the full list of which we have published below.

An NHS announcement stated this first phase will see Martha's Rule in place at the 143 sites from now until March 2025 at the latest.

A wider rollout across the entirety of the NHS in England is also planned.

Martha's Rule itself will consist of three components:

Firstly, an 'escalation process' where both patients and their loved ones can contact a specific outreach team 24/7 via telephone hotline number if they have concerns over their care, and want an 'urgent review', better known as a second opinion.

This team, who Ms Mills said would be 'very used to dealing with very ill patients' will then independently assess the case and 'escalate care if necessary'.

The hotline number will be advertised throughout the hospitals on posters and leaflets, with each number unique to each hospital.

Secondly, NHS staff themselves will also have access to the same team to raise the alarm if they feel a patient in their care is not being escalated adequately.

One example of this could be junior medic having concerns over a patient but having these dismissed by a senior colleague.

Lastly, medics will also formally be required to record anyinsights and information about a patient's health that is noted by a patient's family.

This, the NHS states, will ensure 'any concerning changes in behaviour or condition noticed by the people who know the patient best are considered by staff'.

The exact form of the leaflets and posters to advertise Martha's Rule hasn't been confirmed.

But the NHS said it was working with Martha's parents,Merope Mills, an editor at the Guardian, and her husband Paul Laity, to develop these materials.

On the announcement of the NHS sites taking part in the roll-out Martha's parents said: 'Martha's Rule... will save lives and encourage better, more open, communication on hospital wards, so that patients feel they are listened to, and partners in their healthcare.'

NHS national medical director Professor Sir Stephen Powis, called Martha's Rule 'one of the most important changes to patient care in recent years'.

He added: 'While thankfully the need for escalation of care will hopefully only be needed in a limited number of cases, this three-step safety net has the opportunity to truly transform patient care and safety.'

NHS Providers, a membership organisation for NHS trusts in England, welcomed the rollout.

Its deputy chief executive, Saffron Cordery, said: 'Leaders across the NHS know more needs to be done to improve patient safety and the importance of creating an open and learning culture as the foundation of safe and effective care.

'This is a further helpful step to support that important goal.'