Mother hopes Martha’s Rule will ‘upend’ hospital ward ‘hierarchy’

It is hoped that Martha’s Rule, which gives people and their loved ones the right to a second medical opinion, will “upend” the “hierarchy” on hospital wards, Martha Mills’s mother has said.

Merope Mills, who campaigned with husband Paul Laity to give families more say when it comes to care, following the death of their daughter, also called for a “mutual respect” between patients and doctors.

It comes after more than 140 NHS sites in England signed up to roll-out Martha’s Rule.

The escalation process offers patients and families the power to seek a second opinion if they feel their condition, or the condition of a loved one, is deteriorating and they are not being listened to.

An urgent clinical review would then be carried out by a different team in the hospital.

Martha, 13, died of sepsis in 2021 after suffering a pancreatic injury when she fell off her bike.

Ms Mills and Mr Laity raised concerns about their daughter’s health a number of times but these were brushed aside.

A coroner ruled Martha would most likely have survived if doctors had identified the warning signs of her rapidly deteriorating condition and transferred her to intensive care earlier.

Speaking at NHS ConfedExpo on Wednesday, Ms Mills, an editor at the Guardian, said: “My big thing is, I think we need to be more equal.

“It’s a very unequal place, a hospital ward, and there’s hierarchy and it’s very steep and it’s very strict.

“And you know, when I first started talking about that, I sort of thought the nurses were at the bottom of the hierarchy.

“And I refer to that because, you know, they didn’t feel that ability to speak up in Martha’s case.

“But I’ve actually come to realise that the people at the bottom of the hierarchy are the patients.

“They are the ones with the least power and I just would like to upend that and just have a sense of mutual respect between doctor and patient.”

It was announced in February that Martha’s Rule was expected to be rolled out at at least 100 NHS trusts in England from April.

But last month, NHS England revealed 143 hospital sites would test the rule, which would be available 24/7 and advertised on posters and leaflets throughout hospitals.

Aidan Fowler, national director for patient safety at NHS England, thanked trusts for the “amazing response” to the initiative.

He said: “We aimed at 100 because it felt like a really good start. I knew when we had 10 people apply within the first hour that we were going to exceed that.

“And we’ve had 143 sites and we’ve still got people stepping forward. So that’s an amazing response. So there is enthusiasm out there.”

Mr Fowler said a pilot model was now being developed with the teams that had signed up.

He said: “There are some basic principles that we know about, that have been talked about. But there’s an enormous amount of detail that we’re working through together.

“So it’s manifesting concerns about adult critical care teams going to see children, and what can we do better in the paediatric sphere. How do we introduce this in maternity has been mentioned, or the emergency department.

“Our aim is not to enforce a model on the system, but to develop a model that makes sense to the system.

“We’ll all be doing it once we’ve got a model that we think works. And once we can then develop the ideal model, we will be doing this.

“And we’re already looking at how would we do this in a mental health organisation? How would we do this in the community?

“So it’s coming to you, even if you haven’t signed up already. Be in no doubt about that.”