More than 500 people have received potentially life-saving care thanks to Martha’s rule, which gives hospital patients the right to seek a second opinion about their health.
They were moved to intensive care or a specialist unit after they, a loved one or a member of NHS staff triggered the patient safety mechanism, which the NHS in England began using in 2024.
Martha’s rule lets patients, relatives and staff call a helpline run by the hospital if they are worried about the person’s condition or treatment and ask for a “rapid review” of their care.
In the 18 months between September 2024 and February 2026, a total of 524 adults and children about whom concerns had been raised were moved to an intensive care or high-dependency unit, a specialist hospital or a specialist ward at the hospital where they were already an inpatient.
Wes Streeting, the health secretary, said the figures proved that Martha’s rule is “already having a life-saving impact”. It has been widely hailed as a major advance in patient safety.
Martha’s rule is named after Martha Mills, who died aged 13 in 2021 after her family’s concerns that she was deteriorating went unheeded by staff at King’s College hospital in London.
Her parents, Merope Mills and Paul Laity, campaigned to persuade ministers, NHS leaders and doctors to implement the right to a review of a hospital patient by a different team from the one treating them, which can lead to their care being escalated.
After an inquest into her death a year later, the coroner ruled that Martha would probably have survived if doctors had spotted sooner that she was suffering from sepsis.
NHS England’s latest data on how Martha’s rule is operating shows that 12,301 calls were made to Martha’s rule helplines during those 18 months. About one in three – 4,047 – helped to identify a patient whose health was getting worse. Three-quarters of them (2,967) were made either by a patient and their carer or by the patient themselves. Hospital staff made the other 1,080.
Mills, a senior editor at the Guardian, and Laity said it was “hugely encouraging” that 1,000 clinically trained staff had sought a review.
“This is also clear evidence that issues such as hierarchy, poor communication and some doctors’ resistance to being challenged affect hospital care every day. Such factors are crucial to any explanation as to why Martha lost her life.
“For instance, consultants failed to move her to intensive care, even though at least one nurse identified that’s where she needed to be: had Martha’s rule been in place, the nurse could have called the number.
“The hospital’s escalation protocol on the day of Martha’s severe deterioration was tightly structured around the opinion of the ward consultant on duty, who was at home, didn’t come into hospital, and got everything catastrophically wrong, as a professional tribunal has judged: all the ward doctors were bound by the hierarchy.
“Martha’s rule would have given them more agency and might have encouraged them to take more responsibility,” they added.
An interim review into the operation of Martha’s rule published on Friday found that 32% of the public were aware of the initiative, which hospitals promote using posters and other means. However, those who have been through higher education were four times more likely to have heard of it than others.
Martha’s parents want to help promote “a public conversation about healthcare that explores culture and goes beyond the real problem of stretched resources”.
Paul Whiteing, chief executive of the patient safety charity, Action against Medical Accidents, said: “Too often the people we support still tell us about the culture of defend and deny that they face when they ask questions or raise concerns about their treatment. If this rule is challenging that culture, then its use must be expanded as soon as is possible.”
Streeting said: “Martha’s parents have fought tirelessly to turn the most unimaginable grief into something that is genuinely changing how our NHS works. Merope and Paul pushed for a practical change that puts patients and families at the heart of care – and it’s one that is already having a life-saving impact.
“That takes extraordinary courage, and the NHS owes them an enormous debt of gratitude.
“The NHS is changing its culture and putting patient safety at its heart. Change isn’t always easy, but Martha’s rule is proof that it can be done,” he added.
