Patients and families to get 'urgent second opinion' from NHS if health suddenly deteriorates, in 'Martha's Rule'

21 February 2024, 06:02

Martha's Rule is being rolled out from April
Martha's Rule is being rolled out from April. Picture: Alamy

By Kit Heren

Patients and their families will be able to get an urgent review of how NHS staff are treating them if their health is deteriorating rapidly.

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'Martha's Rule' means that a critical care team will be available 24/7 to review patients' treatment.

At least 100 NHS trusts will bring in the rule, as the scheme is evaluated in 2024 and 2025. All acute hospitals would later roll out the rule, subject to government funding. The scheme will be advertised throughout hospitals.

A different team in the hospital would carry out an evaluation of the patient's health if they are rapidly worsening and they or their family feels they are not getting the care they need.

The rule is named after Martha Mills, who died aged 13 of sepsis in King's College Hospital in south London in 2021. She developed sepsis in hospital, and her parents begged for more urgent care, but were dismissed.

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An inquest found she would likely have lived if she had been moved faster to intensive care.

Martha's parents Merope Mills and Paul Laity said in a statement: "We are pleased that the implementation of Martha's Rule will begin in April.

"We want it to be in place as quickly and as widely as possible, to prevent what happened to our daughter from happening to other patients in hospital.

"We believe Martha's Rule will save lives. In cases of deterioration, families and carers by the bedside can be aware of changes busy clinicians can't; their knowledge should be recognised as a resource.

Martha Mills
Martha Mills. Picture: Alamy

"We also look to Martha's Rule to alter medical culture: to give patients a little more power, to encourage listening on the part of medical professionals, and to normalise the idea that even the grandest of doctors should welcome being challenged.

"We call on all NHS clinicians to back the initiative: we know that the large majority do listen, are open with patients and never complacent - but Martha's doctors worked in a different culture, so some situations need to change.

"Our daughter was quite something: fun and determined, with a vast appetite for life and so many plans and ambitions - we'll never know what she would have achieved with all her talents.

"Hers was a preventable death but Martha's Rule will mean that she didn't die completely in vain."

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NHS chief executive Amanda Pritchard said Martha's Rule had the potential to "save many lives in the future".

She said: "Hearing about the heartbreaking loss of Martha and the experiences of her family has had a major impact for people right across the country, with parents, patients and NHS staff welcoming her parents' call for a simple process to escalate concerns when they can see a loved one's condition worsening.

"NHS teams have been piloting ways to better identify and respond in these cases over the last year, and the roll-out of a national programme to give patients and families 24/7 access to a rapid clinical review will now help ensure that those experiencing acute deterioration can be identified and treated much more quickly.

"I know I speak on behalf of all NHS staff when I thank Merope and Paul for their extraordinary campaigning and collaboration on this hugely important issue.

"While the need for escalation will hopefully only be needed in a small number of cases, I have no doubt that the introduction of Martha's Rule has the potential to save many lives in the future."

NHS teams will also look at ways ways to roll out an adapted Martha's Rule model in community and mental health hospitals.

Rory Deighton, director of the NHS Confederation's acute network, welcomed the move.

He said: "Questions remain about what resources hospitals and other providers will be given to deliver the new scheme.

"Introducing a 24/7 clinical review process will have implementation costs and leaders will be concerned if they are just being expected to provide the additional service without any extra resources.

"But this rollout is part of an important shift where the NHS is looking to change the relationship between the NHS, clinicians, patients and their families.

"The future model of care is one where patients and their families are active partners in healthy communities, not just consumers of NHS services."

Health Secretary Victoria Atkins said: "Martha's death was a terrible tragedy, and I pay tribute to her parents Merope and Paul.

"Martha's Rule will provide a major boost to patient safety by putting in place a system that can be triggered by patients, or by their family and friends, when they are worried that their condition is worsening. This will give vital reassurance that the best care possible is being given.

"The introduction of Martha's Rule from April will put families at the heart of the patient's own care, recognising the critical role they have in the treatment of loved ones."

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