We spoke to Personal Injury and Clinical Negligence Barrister Peter Quegan about the introduction of Martha’s rule.

Martha’s Story

Martha Mills was a 13-year-old who was admitted to the hospital with a pancreatic injury after falling off her bike in 2021. Concerns that Martha’s family had about her deteriorating condition were not addressed at the time. She developed sepsis and tragically died, with the coroner ruling that she probably would have survived had she been moved to intensive care earlier.

Often, it is the family of, or those who are closest to, the patient, who are the first to notice changes that might indicate early signs of deterioration. Thus, it is important to listen, assess, and act upon the concerns of patients, families, and carers.

So, in response to Martha’s case and other clinical deterioration management cases, the Secretary of State for Health and Social Care, along with NHS England, committed to implementing ‘Martha’s Rule’ across the NHS.  

What is Martha’s Rule

First introduced in September 2025, Martha’s rule is a UK patient safety initiative that aims to support the early detection of deterioration. It encourages patients, families, and carers to raise concerns about a health condition worsening with NHS staff, as they could be the first to notice small changes in the patient that could be early warning signs of a deteriorating condition, even precluding the warning signs that are picked up following routine measurements.  

Concerns should be escalated by calling a dedicated number to request a rapid review from a different team if the patient, family member, or caregiver is worried that their concerns, which they shared with staff, are failing to be addressed. Staff can also call for a rapid review if their concerns about a patient are not addressed.

Martha’s Rule – Three Core Components

NHS England lays out Martha’s Rule into three core components as follows:

1. Patients will be asked, at least daily, about how they are feeling, and if they are getting better or worse, and this information will be acted on in a structured way.

2. All staff will be able, at any time, to ask for a review from a different team if they are concerned that a patient is deteriorating and they are not being responded to.

3. This escalation route will also always be available to patients themselves, their families and carers and advertised across the hospital.

The contact number will differ depending on where the patient is receiving treatment. Concerned patients or family members should be able to find the dedicated ‘Call 4 Concern’ telephone number on posters around the ward, by asking a member of staff, or by visiting the trust’s website.

Clinical Negligence Barrister Reacts to the Introduction of Martha’s Rule

Personal Injury and Clinical Negligence Barrister Peter Quegan said, “The news that Martha’s Rule is available in all English acute hospitals is to be welcomed. While my role as a clinical negligence professional is often to secure redress for claimants, my clients have always wanted their loved ones to have received the best care possible. So, I hope that the introduction of Martha’s rule will reduce the volume of clinical negligence cases!

“We all make mistakes. On reflection, it would be most useful if someone points out an error when we can still do something about it. 

“Medics should always act in the best interest of patients and aim to provide outstanding healthcare. As such, medics are highly regarded and held in an almost unique esteem. This can make voicing concerns about treatment challenging.  

“Evidence suggests that the introduction of Martha’s Rule has already saved a significant number of patients from death or serious harm, and it is brilliant to hear this!

“In fact, 2,132 Martha’s Rule escalation calls related to acute deterioration were made between September 2024 and June 2025, and over 10% of these calls resulted in escalations of care that were potentially life-saving.”  

If you have a Clinical Negligence case you need advice or advocacy for, call our Civil Clerks, Michael Jones and Alessandro Saportia-Clark on 0161 832 4036, email Mike@kenworthys.co.uk, Alessandro@kenworthys.co.uk, or fill out our contact form.