Health secretary backs Martha’s rule giving right to second medical opinion

The government has committed to introducing “Martha’s rule” in hospitals, to give families and patients the right to a second assessment if they feel their concerns are dismissed by NHS staff.

Health secretary Steve Barclay said the case for introducing the rule is “compelling” and he would “move quickly” to implement it, particularly in paediatrics.

Martha Mills died in 2021 after developing sepsis while under the care of King’s College Hospital NHS Foundation Trust in south London.

A coroner ruled last year that the 13-year-old would most likely have survived if doctors had identified the warning signs and transferred her to intensive care earlier.

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. King’s is a specialist national referral centre for children with pancreatic problems.

Martha’s mother, Merope Mills, an editor at The Guardian, said she and her husband, Paul Laity, raised concerns about Martha’s deteriorating health a number of times but these were not acted upon.

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, with her mother voicing her concerns to staff that Martha would go into septic shock over a bank holiday weekend.

The couple have since called for Martha’s rule to give patients, families and carers the chance to easily request a second opinion from a senior doctor in the same hospital in the event of a suspected deterioration or serious concern.

Mr Barclay made the decision after a meeting with Ms Mills on Wednesday, and said the case she set out was “compelling”.

“For everyone that has heard it, it is an absolutely heartbreaking case,” he told the BBC. “I’m determined that we ensure we learn the lessons from it and very keen to learn from best international practice.”

The health secretary said there are “international lessons”, particularly from Ryan’s rule in Australia, giving patients a direct line to a second opinion, “and I particularly want to give much more credence to the voice of patients”.

He added: “I think a key part of this measure is ensuring that patients feel heard and can get a second opinion.”

Mr Barclay is prioritising its introduction and is ready to allocate funds to the initiative, he indicated, though it is not known when it will be implemented.

Ms Mills welcomed the government’s decision and said she hoped the rule “will put some power back into the hands of patients and prevent unnecessary deaths”.

Previously, describing what happened to her daughter, Ms Mills said: “At King’s College Hospital, there were no consultants present after the ward round during the weekend when Martha deteriorated, and so when I had doubts about Martha’s care I had no one senior to turn to.

“I mentioned my concerns to a junior doctor when he misdiagnosed her rash, but he ignored me; questioning him further would have involved a confrontation.

“I talked to a nurse, but she said to trust the doctors. I didn’t have the language or knowledge to request a critical care review.

“I had been ‘managed’, I hadn’t been listened to and I felt powerless.

“A national expert on sepsis worked just down the corridor in paediatric ICU (intensive care): had he seen her following a review, we know her treatment would have been utterly different.

“If a patient and family escalation system such as Martha’s rule had existed – and had been clearly advertised around the hospital with posters and stickers – I’m sure I would have used it and it could well have saved Martha’s life.

“Where such systems exist they are used appropriately and effectively – which is why we’d like to see Martha’s rule introduced across the NHS.”