Martha's Rule

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.