Martha’s rule roll-out: how nurses will be involved
Nurses will be part of independent critical care teams patients and families can contact for an urgent second opinion if they have concerns about NHS care
Nurses will be part of independent critical care teams that patients and their families can contact for urgent second opinions if they are concerned about their care in the NHS.
NHS England (NHSE) has announced that ‘Martha’s rule’ will be rolled out to at least 100 NHS hospitals in England from April, with the patient safety initiative giving patients and families round-the-clock access to a rapid review if they are worried about their own or a loved one’s condition.
Critical care teams include senior nurses
Patients and families will be able to trigger an urgent clinical review from a different team in the hospital if the patient’s condition is deteriorating and they feel they are not getting the care they need.
NHSE said the escalation process to critical care teams, which are usually made up of senior nurses, therapists and doctors with level 3 critical care skills and services, will be available 24/7 to patients, families and NHS staff, and will be advertised throughout participating hospitals.
‘Martha’s rule will save lives,’ says mother
The new rule is named in memory of 13-year-old Martha Mills, who died from sepsis at London’s King’s College Hospital NHS Foundation Trust in 2021 after doctors failed to admit her to intensive care despite having several opportunities to do so.
Her mother Merope Mills previously said no senior consultants were present when Martha’s health deteriorated, so she raised her concerns to a junior doctor but had felt ‘ignored’. The trust has since apologised for mistakes in Martha’s care.
Ms Mills said: ‘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.’
Martha’s Rule might be expanded to all acute hospitals
As part of the rule, healthcare staff at participating hospitals will be required to formally record daily insights and information about a patient’s health directly from their parents or families, ensuring any changes in behaviour or condition are noted.
The initial rollout will inform plans for Martha’s rule to be expanded to all acute hospitals ‘subject to government funding’, said NHSE. Teams will also identify ways to roll out an adapted version of the model across other settings, including community and mental health hospitals.
‘Nursing staff are patients’ greatest advocates’
The RCN said safe and effective levels of nursing staff would be ‘crucial’ to the rule’s implementation.
The college’s director for England Patricia Marquis added: ‘Nursing staff are patients’ greatest advocates and stand ready to ensure Martha’s rule has an immediate impact and leaves a lasting legacy.
‘By listening and engaging, nursing staff and other clinicians can not only help to reduce anxiety but also take important steps to improve care and advance learning.’
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