Martha's Rule to be rolled out across three UHBW hospitals

The Bristol Royal Infirmary (BRI), Weston General Hospital and Bristol Royal Hospital for Children (BRHC) have all been selected to test and roll out Martha’s Rule in its first year.

University Hospitals Bristol and Weston NHS Foundation Trust will be implementing the new initiative across three of its sites, alongside another 140 hospitals, with all partners involved aiming to have the first phase of the programme in place by March 2025.

The purpose of Martha’s Rule is to provide a consistent and understandable way for patients and families to seek an urgent review if their, or their loved one’s condition deteriorates, and they are concerned this is not being responded to.

The scheme is named after Martha Mills, who sadly died from sepsis aged 13 in 2021. She was being treated at King’s College Hospital, London. Her family raised concerns about her deteriorating condition following a cycling injury, but staff did not transfer her to intensive care.

Evaluation of how the system works over the course of this year will inform proposals for Martha’s Rule to be expanded further across all acute hospitals, subject to future government funding.

Once the initiative is in place an escalation process will be available 24/7 at the BRI, Weston General Hospital and BRHC. This will be advertised throughout the hospitals on posters and leaflets.

NHS staff will also have access to this same process if they have concerns about a patient’s condition.

Finally, alongside this, clinicians will also formally record daily insights and information about a patient’s health directly from their families, ensuring any concerning changes in behaviour or condition noticed by the people who know the patient best are considered by staff.

Merope Mills and Paul Laity, Martha’s parents, said: "We are pleased that the roll-out of Martha's Rule is off to a flying start and that the need for it has been so widely recognised.

“It will save lives and encourage better, more open, communication on hospital wards, so that patients feel they are listened to, and partners in their healthcare."

Professor Sir Stephen Powis, NHS national medical director, said: “Rolling out Martha’s Rule to over 143 NHS sites in this first phase will represent one of the most important changes to patient care in recent years, and we are pleased to have seen such interest from hospitals right across the country, all thanks to the moving and dedicated campaigning by Martha’ parents, Merope and Paul.

“That is why today is such an important milestone, with the NHS outlining the 143 sites where this major patient safety initiative will be rolled out later this year, allowing staff, patients and families to immediately raise concerns and bring about an escalation in care in an easily recognisable and fast way.

“The inclusion of daily insights from families about their loved ones’ condition within patient records is also a really significant step and will help staff identify changes and deterioration using insights from those who know the patient best. While thankfully the need for escalation of care will hopefully only be needed in a limited number of cases, this three-step safety net has the opportunity to truly transform patient care and safety.”