Martha's Rule
What is Martha's Rule?
Martha's Rule is a patient safety service for inpatients and their families (previously known as "Call for Concern").
Martha's Rule allows hospital inpatients and their families, carers or advocates to seek a review if their condition, or the condition of a loved one, is deteriorating.
The service is available 24 hours a day, seven days a week.
Martha Mills
This patient safety service was founded following the death of Martha Mills. Martha died in 2021 after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling on her bike. Martha's family raised many concerns about her deteriorating condition however these were not responded to.
In 2023 a coroner ruled that Martha, aged 13, would probably have survived had she been moved to intensive care earlier.
You can find more information about Martha's Rule here:
About Martha's Rule (NHS England)
Who runs Martha's Rule?
The Martha's Rule safety initiative is run by a team of specialist adult critical care nurses who are available 24 hours a day to help support ward staff with the care of very unwell patients within the RUH.
They will offer advice over the telephone and/or come to the ward to review a patient's condition.
The team can also discuss your concerns with the relevant consultant or team. They will review the patient and consider whether any further interventions are required. Consent will be gained from the patient before discussing next steps with the ward team and you will then be updated as needed.
When to call Martha's Rule
What to do if you're worried
- First, speak to the team caring for your loved one
- If, after speaking to the care team, you remain worried and feel your concerns are not being addressed, please telephone 07775 821211
This is an answer machine service. You will need to leave a message providing the following information:
- Your name and the name of the patient and a contact number
- The ward you or they are on
- A brief description of your concerns
Once you have left a message one of the team will call you back as soon as possible. Please be aware the team are unable to give a call back time as they may be with other patients, however, they will call you back as soon as they can.
For further information please see Martha's Rule leaflet:
Martha's Rule – Information for patients and relatives
When not to call Martha's Rule
- Martha's Rule is a patient safety service. It should not be used to report general problems such as issues with bed, room, ward or parking. These are to be dealt with by the ward team.
- Martha's Rule is for a service for acute deterioration. If it is for a general medical/surgical update or a second opinion related to a diagnosis this is to be referred to the Nurse in Charge, Ward Manager or Matron and parent team for escalation.
The difference between the Martha's Rule Service and a general second opinion
The Martha's Rule Service is for staff, inpatients or their friends/families to ask for a review if the patient's condition is deteriorating and after raising concerns with the team on the ward it has not been resolved.
Calls for a medical update or second opinion not related to acute deterioration will be referred back to the ward team, nurse in charge and ward manager to resolve/escalate as appropriate. Escalation of such calls where required can be made to ICU matron (in hours) and or on call/duty matron.
Where the call is related to acute deterioration the CCOT team will provide input, carry out a physical assessment and advise and escalate accordingly.