Martha’s Rule

What is Martha’s Rule?

Martha’s Rule helps us notice early signs that someone may be deteriorating and gives you the right to request a rapid review if you’re worried that your or your loved one’s condition is getting worse.

This may include a review by the Critical Care Team.

Sometimes small changes happen before they show in tests. These can be early warning signs. Martha’s Rule makes sure we listen to concerns and act on them.

It has three main parts:

• Daily check-ins – a nurse will ask each day if you feel better, worse, or the same.
• Staff can act quickly – any staff member can ask for a rapid review if they are worried.
• You can ask for help directly – patients, families and carers can contact a specialist team if they are still worried.

How we monitor patients

While someone is in hospital, we regularly check their vital signs and other important health measurements. The frequency of these checks will depend on the patient’s individual condition and needs. Sometimes we may need to wake patients to do these checks.

In addition, we will also ask at least daily if patients are feeling better or worse. This is to monitor any unexpected changes in their condition.

What to do if you’re worried

1. First, speak to the team caring for you or your loved one
2. If, after speaking to the care team, you remain worried and feel your concerns are not being addressed, contact the Martha’s Rule team. You can call or send a WhatsApp message at any time (24 hours a day, 7 days a week).

Your call will go to a different team in our hospital, who specialise in the care of critically ill patients. They will work with your or your loved one’s care team to arrange any treatment needed or further review.

A staff member will:

• Listen to you
• Ask a few questions
• Decide what needs to happen next

Please be ready to tell them:

• The patient’s name
• The ward name
• What you are worried about
• What has been done so far
• Your contact details and your relationship to the patient

Our commitment

We will regularly ask for your views and take your concerns seriously. We see you as a partner in the care we are providing and want you to raise any worries and concerns you may have.

We will explain what happens next and keep you updated.

Difference between Martha’s Rule and second opinion

Martha’s Rule allows hospital inpatients and their families to seek a rapid review if their condition, or the condition of a loved one, is deteriorating.

A second opinion is when you would like to see another consultant to discuss any diagnosis or treatment.

About Martha

Martha Mills died in 2021 after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling off her bike. Martha’s family’s concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that Martha, aged 13, would probably have survived had she been moved to intensive care earlier.

For more information visit the NHS website.