Martha's Rule helplines get more than 1,700 calls from worried NHS staff

New data reveals that NHS staff in England have made over 1,700 calls to helplines established under Martha’s Rule, a scheme introduced to raise alerts about patient care concerns. These helplines were created in response to a campaign led by the parents of Martha Mills, a 13-year-old girl who tragically died due to significant failings in her treatment at King’s College Hospital, London, in 2021.

Following the unfortunate death of Martha Mills from sepsis, it became apparent that her family’s warnings about her deteriorating condition were not adequately addressed. In 2022, a coroner determined that Martha might have survived had she been transferred sooner to intensive care and received appropriate treatment in time. This ruling highlighted the urgent need for a system that empowers families, carers, patients, and healthcare professionals to speak up when patient health declines.

Martha’s Rule encourages anyone involved in a patient’s care to raise concerns and request an urgent review by a critical care team if their worries are dismissed. The scheme also involves clinicians collecting daily feedback regarding a patient’s condition directly from families. Importantly, healthcare staff—including those in junior positions—are able to seek independent reviews outside their usual team, helping to overcome the often rigid hierarchies in medical settings. The helplines, operational at 143 hospital sites across England since September 2024, have helped identify severe patient deteriorations in more than 1,000 out of almost 1,800 calls made until February.

Anna Mills, Martha’s mother, emphasized the value of the helplines as a “non-confrontational” way for staff to raise concerns, acknowledging the challenges junior staff face in speaking up within the “extremely hierarchical” medical system. She reflected on a nurse involved in her daughter’s care whom she believed would have used the helpline if it had existed at the time. Looking back, Mills contemplates the difference the helpline might have made during Martha’s hospital stay. NHS England’s National Director of Patient Safety, Aidan Fowler, reports that although not every call directly prevented a fatality, the system has demonstrated significant benefits. More than 500 patients have been transferred to intensive care following helpline interventions, and approximately 1,500 patients have received vital changes in care, such as antibiotics or fluids administered in ward settings, potentially saving lives.

The NHS is now moving to broaden this initiative beyond its current scope, extending it to adult and pediatric wards initially, with plans to include maternity, neonatal, and emergency departments in the near future

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