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Martha's Rule

What we need to know

Ciara Collins 24 May 2024

Phase one of Martha's Rule will be implemented in the NHS in April 2024. Once fully implemented; patients, families, carers and advocates will have access to a rapid review from a separate team if they are worried about a persons condition or treatment plan.

This rule will a have an immediate impact on critical care outreach teams who will be required to carry out the rapid review and refer accordingly.

Martha Mills died in 2021 after developing sepsis in hospital. Martha's family raised concerns about her deteriorating condition but were not responded to. In 2023 a coroner ruled that Martha would probably have survived if she had of had intensive care treatment earlier.

In response to this and other similar cases 'Martha's Rule' was developed. This will ensure that the important concerns of the patient and those who know them best are listened to and acted upon.

The rule has 3 components, which are:

  1. All staff in NHS Trusts must have 24/7 access to a rapid review from a Critical Care Outreach Team who they can contact if they have concerns about a patient.
  2. All patients, their families, carers and advocates must also have access to the same 24/7 rapid review from a critical care outreach team. They should be able to contact the team themselves and contact details should be advertised around the hospital.
  3. The NHS must implement a process which allows information to be obtained from the patient and/or their family/advocate regarding their condition. This must be done daily. Initially this will cover all inpatients in acute and specialists trusts.

Implementation of Martha's Rule

The implantation of Martha's Rule will take a phased approach, beginning with sites who already offer 24/7 critical care outreach cover. The initial focused approach on the provider sites during 2024/25 will inform the development of the wider national roll out which will take place over 2025/26. There are also plans to roll out an adapted Martha's Rule model across other settings such as community and mental health hospitals.

Ciara Collins

Ciara Collins

Chair of Critical Care and Flight Nursing Forum

Critical Care Matron

Ciara currently work as a critical care matron. She has 18 years experience in critical care nursing, specialising in cardiothoracic, transplantation and mechanical life support.

Page last updated - 22/10/2024