Martha’s Rule: The Latest

It has been announced that Martha’s Rule, a scheme introduced by NHS England following the tragic death of Martha Mills in 2021, is to be rolled out to all hospital emergency departments across the country. We first wrote about Martha’s Rule in 2023, and a link to that article can be found below.

Martha’s Rule enables patients, families and hospital staff who have concerns about the treatment provided to a patient, or who notice signs of deterioration in a patient’s condition, to request an urgent review from a different clinical team. The scheme is named after 13-year-old Martha Mills who sadly passed away after developing sepsis following her admission to King’s College Hospital in 2021 after a cycling accident. A coroner’s inquest ruled that Martha’s life could have been saved had her parents’ concerns about her condition been listened to and appropriate treatment provided at an earlier stage.

Roll Out

Following a successful pilot scheme in 2024, Martha’s Rule was rolled out to all hospital trusts in England providing inpatient services. The scheme provides wards with a dedicated phone number which can be contacted to request an urgent review where staff and/or family members notice signs or symptoms that the patient’s condition is worsening.

The three core components of Martha’s Rule are:

1. 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.
2. 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.
3. The escalation route will also always be available to patients themselves, their families and carers and advertised across the hospital.

Extension of the Scheme

The success of Martha’s Rule in identifying early signs of deterioration in patients has led to the scheme being extended to maternity and neonatal settings across England. This follows Donna Ockenden’s report on maternity care and services, published in June 2026, which highlighted a number of failings, including instances where women and families had felt their concerns had not been listened to. It is hoped that the latest expansion of Martha’s Rule into hospital emergency departments will be completed by March 2028.

Our 2023 article on Martha’s Rule can be found here.

If you would like advice regarding a medical negligence claim, our specialist Personal Injury & Medical Negligence Team would be happy to assist, please contact the team on 01603 610911 or email info@leathesprior.co.uk.