Martha’s Rule active in every acute hospital across England
- Sep 9, 2025
- 1 min read
Martha’s Rule has completed a nationwide roll-out, now operating in all 210 acute hospitals in NHS England. The scheme gives patients, families, and staff the right to trigger a rapid clinical review if they believe a patient’s condition is deteriorating and concerns are not being acted upon.
A rapid clinical review means that a senior, independent medical team, not previously responsible for the patient’s care, must assess the situation urgently. This can lead to immediate interventions such as transferring the patient to intensive care, ordering further tests, prescribing new medication, or simply challenging an initial care plan.
The speed of this change is remarkable. Martha’s Rule was only proposed in 2022, following the death of 13-year-old Martha Mills from sepsis after signs of deterioration were missed. Her parents, Merope and Paul, campaigned tirelessly for a formal right to escalate concerns, ensuring families have a direct pathway to seek a second opinion. In less than three years, what began as a campaign born of tragedy has become a standard NHS process nationwide, a pace of change rarely seen in healthcare systems.
Early results show its impact. Between September 2024 and June 2025, nearly 4,906 calls were made through Martha’s Rule, leading to 241 confirmed interventions. In practical terms, that has meant hundreds of patients received a level of care that might otherwise have been delayed or overlooked.
NHS England describes Martha’s Rule as a cultural as well as a clinical shift: one that acknowledges that patients and families are often the first to notice when “something isn’t right.” By embedding their voice formally into escalation pathways, hospitals are recognising that listening can save lives.