St Clement’s Blog – Martha’s Rule

Who was Martha?

Martha Mills was a 13-year-old girl who died from sepsis in 2021 after being admitted for an injury she sustained whilst cycling on holiday. She was admitted to hospital and during her admission she developed an infection and sadly passed away. Her mother, Merope Mills, had raised concerns to Martha’s team multiple times but had been told that Martha did not need intensive care. In a subsequent investigation into her death, the coroner noted that there had been fundamental issues with her care and that, had she been admitted to intensive care ward earlier, then she would very likely have survived.

What is Martha’s Rule?

Martha’s rule would give patients and their families in hospital the legal right to a second opinion from a senior medical team when they are deteriorating (becoming more unwell) rapidly, and do not feel their concerns are being addressed.

How would it work?

This is still to be decided by individual hospitals, but it is likely that you would be given the contact number of the critical care team who would come and review the patient and give their opinion about whether they need a change to their care. Hospitals would be obliged to clearly display the contact details for the team in every ward in the hospital.

Does this exist anywhere already?

Yes – Call 4 Concern has been adopted by some hospitals in the UK already. Patients or relatives can call or ‘bleep’ the Critical Care Outreach Team 24 hours a day who will review anyone who is deteriorating rapidly. A similar law exists in Australia called Ryan’s Rule. Both have been positively received by the public.

Is this rule in place already?

The health secretary Steve Barclay has given his support to Martha’s Rule and has indicated he will provide funding to support it being rolled out throughout England. Hospitals may require time to organise the service and arrange staffing so it may be several months before it is up and running locally.

What does it mean for me or my family?

If you are a patient in hospital, or have a relative in hospital, you will be able to seek a second opinion from a senior medic trained in critical care to ensure that you are receiving appropriate medical care. While Martha’s rule has not yet been formally adopted by all hospitals in the UK, when in hospital you should feel empowered to ask for second opinions if you feel that your condition is worsening and your concerns are not being taken into consideration.

Where can I find out more?

You can read more about Martha Mills, Martha’s rule and the background behind the rule at the Demos website below: