Martha’s Rule to Expand Across England’s A&Es

A PATIENT-SAFETY initiative that provides patients, relatives, and NHS staff another route to raise concerns about deteriorating health will be expanded to every accident and emergency department in England.

Martha’s Rule, inspired by a teenage girl who died after receiving inadequate care, allows people to contact a dedicated hospital helpline when they believe a patient’s condition is worsening and their concerns are not being addressed.

A separate clinical team can then conduct an urgent review and recommend changes to the patient’s care.

The expansion will include A&E waiting rooms and is expected to be completed in phases by March 2028. NHS England described the service as a “critical new lifeline” that could improve care and save lives.

Calls Lead to Potentially Life-Saving Care

Martha’s Rule was introduced in England in 2024 and is now available across all acute hospitals. It was also extended to every maternity and neonatal unit in England in June 2026.

During the scheme’s first 16 months, hospital helplines received more than 10,000 calls. These resulted in 446 patients receiving changes to their care that may have saved their lives. Interventions included transfers to intensive care, the provision of medicines, and other alterations to treatment.

A pilot across seven NHS trusts examined whether the system could operate safely within busy emergency departments. Sixty-nine calls were made during the eight-month trial, with some patients subsequently undergoing urgent surgery or being transferred to intensive care.

July 2026 saw a record 1,678 calls to Martha’s Rule helplines, the highest monthly figure since the initiative began.

Dr Aidan Fowler, National Director of Patient Safety at NHS England, said about the promising numbers: “Martha’s Rule is already helping to save lives and transform the culture of the NHS – with 10,000 calls made to the helplines in just over a year and over four hundred potentially life-saving interventions triggered.

“These figures show that Merope and Paul’s tireless campaigning and the hard work of staff are helping the NHS listen to families more effectively and shows that when concerns are raised, hospital teams are ready to respond.”

Rule Created After Teenager’s Death

The rule is named after Martha Mills, who died from sepsis in 2021 at the age of 13 after sustaining an injury in a bicycle accident.

A coroner concluded that Martha would probably have survived if she had been transferred to intensive care at King’s College Hospital, London, when her condition deteriorated.

The inquest into her death identified multiple missed opportunities for doctors to escalate her level of care that could have saved her life. Her parents, Merope Mills and Paul Laity, subsequently campaigned for a formal mechanism enabling patients and families to seek an urgent second opinion, which they now believe could have saved their child’s life at the time.

Under the A&E expansion, patients, relatives, and staff will be able to call a dedicated number when they believe someone’s condition is worsening and their concerns have not received an adequate response.

The phased rollout in England will be completed by March 2028.

Patients and their families can check with their local hospital or NHS trust where Martha’s Rule is available by visiting the trust’s website or asking hospital staff.

Featured image: Alex Yeung on AdobeStock