Patient safety initiative – Martha’s Rule – launched across Norfolk hospitals

Norfolk’s three acute hospitals have launched an important patient safety initiative named Martha’s Rule across all services, including departments looking after children and babies.

Martha’s Rule gives patients and their loved ones the chance to voice any concerns they may have and know they will be taken seriously. It is a vital way of helping improve patient safety.

This nationally developed rule is named after Martha Mills, who died in London in 2021 aged 13 after developing sepsis in hospital where she had been admitted with a pancreatic injury after falling off her bike. Hospital staff did not respond to family concerns about her deteriorating condition and in 2023 a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier.

The rule introduces three key components:

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

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

• Escalation routes are available to patients themselves, their families and carers and advertised across the hospitals.

Patients are asked regularly about whether they feel their condition is getting better or worse to provide opportunities for them to raise concerns.

Patients, their loved ones, and staff, will also have access to a dedicated Martha’s Rule phone line. Through this they can seek an independent review from staff specialised in identifying deterioration should they feel a patient’s condition is getting worse.

The introduction of Martha’s Rule replaces a previous pilot scheme run in James Paget University Hospital, Norfolk and Norwich University Hospital, and The Queen Elizabeth Hospital King’s Lynn. That scheme was called ‘Call for Concern’ and was implemented in specific areas of their hospitals.

‘Martha’s rule’ is the new name for this enhanced and extended service which is now being implemented throughout all areas of the hospitals.

Rachael Cocker, Chief Nurse at Norfolk and Waveney University Hospitals Group, said: “Martha’s Rule empowers family and friends of patients to speak up and be listened to knowing prompt action will be taken.”

Notes to editors

More information is available from NHS England.

Across Norfolk the three hospitals have seen the Call for Concern number be called 20 times on average per month.