Martha's Rule to be extended to all A&E departments in England

Martha's Rule, a patient safety initiative that allows patients, their families, and healthcare staff to request a second medical opinion on care, is being expanded to all accident and emergency (A&E) departments across England. This nationwide rollout aims to provide a critical mechanism for challenging care decisions and potentially saving lives.

The initiative is named after Martha Mills, a 13-year-old who died in 2021 from sepsis at King's College Hospital in London. A coroner's report found that Martha likely would have survived if she had been transferred to intensive care earlier and received appropriate treatment, noting that her family's concerns about her deteriorating condition were not adequately addressed.

Following a successful pilot in seven NHS trusts, the expansion to all A&E departments will begin immediately and is expected to be completed by March 2028. During the eight-month pilot, 69 calls were made to dedicated Martha's Rule phone lines, resulting in some patients receiving urgent surgery or being transferred to intensive care. The rule has also been rolled out across all inpatient wards and maternity and neonatal units.

Prof Aidan Fowler, national director of patient safety at NHS England, stated that the expansion offers a "critical new lifeline" for patients and staff, emphasizing its effectiveness in busy A&E settings. Health minister Baroness Merron highlighted the initiative as part of broader efforts to prioritize patient safety within the NHS. Scotland is beginning to adopt Martha's Rule, Northern Ireland is considering it, and Wales has a similar scheme called Call4Concern.