NHS to roll out ‘Martha’s rule’ following 13-year old’s death

Families will be able to request an urgent review from hospitals if they are worried about the condition of a loved one in critical care as the NHS plans to roll out “Martha’s Rule”.

The government had promised to introduce the new rule last year following a campaign by the parents of 13-year-old Martha Mills, who died from sepsis in 2021 after staff at King’s College Hospital failed to move her to intensive care despite her family warning them her condition had deteriorated.

NHS England chief executive Amanda Pritchard has now announced that 100 hospitals with critical care units will be invited to sign up for the initiative, which will be rolled out from April.

The hospitals would allow patients to access so-called critical care outreach teams around the clock to review patients if they get worse while in hospital. These teams, which currently exist in some NHS trusts, would be made up of senior nurses, therapists and doctors.

Participating hospitals will be expected to also record daily information on a patient’s health after speaking directly with their patients and families.

There are currently 137 hospitals with critical care beds, with the remaining hospitals due to adopt the scheme next year.

Martha’s parents Merope Mills and Paul Laity welcomed the move. They said in a statement: “We believe Martha’s Rule will save lives. In cases of deterioration, families and carers by the bedside can be aware of changes busy clinicians can’t; their knowledge should be recognised as a resource.

“We also look to Martha’s Rule to alter medical culture: to give patients a little more power, to encourage listening on the part of medical professionals, and to normalise the idea that even the grandest of doctors should welcome being challenged.”

“Our daughter was quite something: fun and determined, with a vast appetite for life and so many plans and ambitions – we’ll never know what she would have achieved with all her talents. Hers was a preventable death, but Martha’s Rule will mean that she didn’t die completely in vain."

Martha was being looked after at King’s after suffering a pancreatic injury following a fall from her bike while on a family holiday in Wales.

An inquest heard there were several opportunities to refer Martha to intensive care but this did not happen. The trust, which is a specialist national referral centre for children with pancreatic problems, has since apologised for mistakes in Martha’s care.

At one point, Martha began to bleed heavily through a tube inserted into her upper arm and through a drainage tube.

She also developed a rash and her mother voiced concerns to staff that Martha would go into septic shock over a bank holiday weekend.

One of the trust’s own intensive care doctors told the inquest into Martha’s death he would “100 per cent” have admitted her if he had seen her.

Expansion of the project will be subject to government funding, the NHS said. It added that it will explore future ways to adapt Marth’s rule to other settings such as mental health hospitals or community services.

Ms Pritchard said: “Hearing about the heartbreaking loss of Martha and the experiences of her family has had a major impact for people right across the country, with parents, patients and NHS staff welcoming her parents’ call for a simple process to escalate concerns when they can see a loved one’s condition worsening.”

She added: “I know I speak on behalf of all NHS staff when I thank Merope and Paul for their extraordinary campaigning and collaboration on this hugely important issue – while the need for escalation will hopefully only be needed in a small number of cases, I have no doubt that the introduction of Martha’s Rule has the potential to save many lives in the future.”