Martha’s Rule: A Life-Saving Safety Net Now Rolled Out Across England
Posted on in Medical Negligence
At Tozers, our medical negligence team has been closely following the progress of Martha’s Rule - a vital initiative that empowers patients and families to escalate medical concerns when they feel their voices are not being heard.
We are encouraged to see this rule now rolled out across all English hospitals delivering acute or short-term treatment, as reported by the BBC on what would have been Martha Mills’ 18th birthday Martha's rule rolled out to all acute hospitals in England - BBC News
The Story Behind the Rule
Martha Mills tragically died in 2021 at King’s College Hospital in London after developing sepsis. Despite her family raising repeated concerns about her deteriorating condition, their warnings were not acted upon. In 2022, the inquest found that Martha would probably have survived had she been transferred earlier to intensive care and received appropriate treatment.
Her death sparked a nationwide campaign by her parents, Merope and Paul Mills, which led to the creation of Martha’s Rule.
What is Sepsis
The UK Sepsis Trust defines sepsis as a life-threatening condition that arises when the body’s response to an infection injures its own tissues and organs, with the immune system going into overdrive.
It can lead to shock, multiple organ failure, and even death if not recognised and treated promptly.
What is Martha’s Rule
Martha’s Rule is a dedicated pathway for patients, families, including junior NHS staff, to request an urgent second opinion from a critical care team when they believe someone is deteriorating and not being properly treated. It reiterated the message from The UK Sepsis Trust – Just Ask – Could it Be Sepsis?
The Impact So Far – from Pilot to National Roll-Out
The scheme, piloted in 143 hospitals since April 2024, has already made a tangible difference in the UK.
According to NHS England data published by the BBC, there have been:
- 4,906 calls made to Martha’s Rule helplines
- 720 interventions leading to changes in care (e.g., administration of antibiotics)
- 794 calls that helped speed up delayed investigations or treatments
- 1,030 calls that resolved communication failures or discharge issues
- 241 cases where the intervention was deemed potentially lifesaving
Looking at the statistics, 71.9% of these calls came from families, demonstrating just how crucial it is to empower loved ones to advocate for patient care.
Martha’s mother, Merope Mills, told BBC Radio 4’s Today programme that the initiative is already saving lives and underlined the urgent need for a more equal, patient-centred healthcare culture.
Her call for UK-wide adoption of the rule, now also including in maternity services, has been echoed by Health Secretary Wes Streeting, who acknowledged similar failings across the NHS and committed to sharing these results with other nations of the UK.
A Step Toward Accountability and Culture Change
The expansion of Martha’s Rule represents not just a procedural improvement, but it also demonstrates a cultural shift in how the NHS responds to concerns. Importantly, the scheme allows:
- Families and carers to request urgent reviews when their concerns are ignored
- Daily clinical updates to be informed by family insights
- NHS staff, including junior clinicians, to request reviews by independent teams
Why This Matters in the Context of Sepsis
Around 245,000 sepsis cases occur each year in the UK, resulting in about 48,000 deaths, killing more people than breast, bowel, and prostate cancer combined.
An additional 10,000 of those deaths are considered avoidable.
Hospital admissions due to sepsis have risen from 27.9 per 100,000 in 1998 to 210.4 in 2023, marking a more than 7-fold increase.
According to The UK Sepsis Trust, of survivors, nearly 40% suffer cognitive, psychological, or physical after-effects, affecting around 78,800 people annually.
Sepsis Awareness Month & The UK Sepsis Trust
September marks Sepsis Awareness Month, with the UK Sepsis Trust front and centre in raising awareness.
The campaign includes the “Step Up To Sepsis” initiative, which encourages public participation in walking or fundraising to support sepsis education.
The Trust also empowers public action through its "Just Ask: Could it be Sepsis?" initiative, urging families and professionals to speak up early
Why Martha’s Rule Matters
Matha’s Rule ensures urgent medical deterioration concerns, especially in sepsis cases, are heard and acted upon.
It aims to bridge gaps in care communication, often where family advocacy can be lifesaving.
In the context of sepsis, where early intervention is critical, such mechanisms can literally mean the difference between life and death.
What This Means for Families Affected by Sepsis
Sepsis is a medical emergency.
Time is critical, and when early signs are missed or warnings go unheeded, the consequences can be devastating.
Martha’s case is, heartbreakingly, not unique, and we act for clients who have been victims of the devastating effects of this condition.
Summary
- Martha’s Rule is now live in all acute hospitals in England, with thousands of families already using the hotline.
- It has now been rolled out to maternity units across the UK.
- The scheme has already led to hundreds of critical interventions and likely saved lives.
- The legal and cultural significance of this change cannot be understated.
If you believe you or a loved one experienced negligence due to unrecognised or untreated sepsis, we are here to help.
At Tozers, our specialist medical negligence team regularly supports families who have suffered the consequences of delayed or inadequate sepsis treatment.
If your family has been affected by sepsis or similar failures in hospital care, contact our dedicated medical negligence team for a confidential consultation.