What is Martha's Rule and how can it help patients in Dudley?

When you or someone you care about is in hospital, you know them better than anyone else. Sometimes you may notice small changes in their condition before they appear in tests or observations.

That's why the NHS introduced Martha's Rule, a patient safety initiative designed to make sure concerns raised by patients, families and carers are listened to and acted upon. Martha Mills' family campaigned for the change after concerns about her deteriorating condition were not acted upon while she was in hospital.

What is Martha's Rule?

Martha's Rule is an NHS patient safety initiative that helps patients, families and carers raise concerns if they believe a hospital patient's condition is getting worse and those concerns are not being responded to. It is designed to support the early detection of deterioration and ensure that concerns are acted upon.

Who is Martha's Rule named after?

Martha's Rule is named after Martha Mills, who died in 2021 after developing sepsis while in hospital. Following her death, her family campaigned for a system that would allow patients and families to request an urgent review when they felt concerns about a patient's condition were not being heard.

What does "patient deterioration" mean?

Patient deterioration means a person's health condition is getting worse.

This could include:

Increased pain
Difficulty breathing
Changes in behaviour or alertness
New symptoms developing
Symptoms becoming more severe
Concerns that a patient is not improving as expected

Often, family members and carers are the first to notice that something is not right. Martha's Rule recognises the importance of listening to those concerns.

How does Martha's Rule work?

Martha's Rule has three key parts:

Patients should be asked regularly how they are feeling and whether they believe they are getting better or worse.
Hospital staff can request a review from another team if they are concerned about a patient's condition.
Patients, families and carers can also request a rapid review if they feel concerns about deterioration are not being addressed.

Can family members use Martha's Rule?

Yes.

If you are a relative, carer or someone supporting a patient in hospital, you can raise concerns if you think their condition is getting worse.

Martha's Rule recognises that those closest to a patient may notice signs of deterioration before healthcare professionals identify them through routine observations.

When should I use Martha's Rule?

You should consider using Martha's Rule if:

You are worried about a patient's condition.
You think they are getting worse.
You have already spoken to staff about your concerns.
You do not feel your concerns are being addressed.

Martha's Rule is intended to provide an additional route for escalation when concerns remain unresolved.

How do I use Martha's Rule in Dudley?

In Dudley, Martha's Rule is sometimes called 'Call for Concern'.

If you are concerned, follow the 3 steps:

Speak to the patient’s healthcare team about your concerns.
If you’re not satisfied with the response you have received, ask to speak to the nurse in charge.
If you are still not satisfied that your concerns have been addressed and the clinical condition is deteriorating, this is the time to place a Call for Concern.

The Critical Care Outreach team run the service 24/7 and will respond quickly, assess the situation and work with medical teams and other healthcare staff as needed.

Call for Concern

07976 767471 or ask switchboard to put you through.

Will using Martha's Rule affect someone's care?

No.

Martha's Rule is designed to improve patient safety. Patients, families and carers should feel confident speaking up if they have concerns about a patient's condition. The initiative encourages a culture where concerns are listened to and acted upon.

Young people helping to raise awareness of Martha's Rule

To help more people understand Martha's Rule, the Dudley Young Health Champions from King Edward VI College, Stourbridge, worked alongside senior NHS colleagues and independent artists to create a new awareness film.

The project highlights the importance of speaking up when a patient's condition is deteriorating and encourages patients, families and carers to understand the support available to them.