Martha’s rule: nurses could be key in ‘second opinion’ process
Ministers will consult bereaved mother of Martha Mills and are looking to established practice in Australia, where nurses are central to securing second opinion
Nurses could be closely involved in a new process to make it easier for patients and families to raise concerns about their care in the NHS.
The government is considering introducing ‘Martha’s rule’, which would aim to create a formal process for families wanting to secure a second medical opinion if they do not think a patient’s health is improving as expected.
It would be named in memory of 13-year-old Martha Mills, who died from sepsis in hospital after doctors failed to admit her to intensive care despite having several opportunities to do so.
Her mother Merope Mills told the PA news agency that no senior consultants present at King’s College Hospital Foundation Trust in London when Martha’s health deteriorated so Ms Mills raised her concerns with a junior doctor, but had felt ‘ignored’.
The trust has since apologised for mistakes in Martha’s care.
Health and social care secretary in England Steve Barclay confirmed this month the government is looking to implement Martha’s rule. It would be similar to ‘Ryan’s rule’ in Queensland, Australia – a three-step process that allows patients or their families to request a clinical review of their case by a nurse or doctor. Nurses are involved in every step.
Enabling patients and relatives to secure a second opinion: Ryan’s rule
Step 1 Families can talk to a doctor or nurse about their concerns. If they are not satisfied, they go to the next step
Step 2 Talk to the nurse in charge of the shift
Step 3 Relatives can use a designated helpline or ask a nurse to call it on their behalf and request a ‘Ryan’s rule clinical review’
Source: Queensland Government
Listening to concerns improves care and learning
Mr Barclay is due to meet Ms Mills on 13 September to discuss the proposal, according to the BBC.
The NHS is looking at how to strengthen speaking-up processes for staff as well as patients in light of Martha’s death and the case of Lucy Letby –consultants’ fears about the serial killer nurse were not addressed for a year.
The RCN said nursing staff are acutely aware of the importance of listening to patient’s questions and concerns.
‘By listening and engaging you can improve care, reduce anxiety, and even improve learning for all those involved,’ a spokesperson said.
Second opinion: hospital helpline model
Former chief nurse at Royal Berkshire NHS Foundation Trust Eamonn Sullivan told Nursing Standard a helpline set up at Royal Berkshire Hospital could be replicated elsewhere in the NHS.
Patients or their relatives can call the Call 4 Concern helpline for advice, which prompts a patient review by a senior critical care nurse who can then take the matter further.
The helpline has received three calls a month, on average, in the past year, Mr Sullivan said.
‘It’s free and it has been very well received since it was set up in 2010. Trusts can do something similar with existing resources, staff, and it doesn’t overwhelm systems.’
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