Martha’s rule, a patient safety initiative that allows NHS patients, relatives, and staff to request an urgent clinical review, is expanding to every emergency department across England, health officials have announced. According to NHS England, the system provides a crucial lifeline for vulnerable patients in busy waiting rooms and treatment areas by granting the right to demand a second medical opinion when a condition deteriorates and initial concerns go unheard.
Martha’s Rule Expands to Every A&E in England
The nationwide emergency department rollout will be completed in phases by March 2028, following a pilot program across seven hospital trusts. During an eight-month trial in those trusts, 69 calls were made to the dedicated helpline, resulting in urgent surgeries and patient transfers to intensive care, according to NHS England data. Prof Aidan Fowler, director of patient safety at NHS England, stated that emergency departments see some of the most vulnerable patients in the healthcare system, making rapid reviews essential for safe care.
The system originates from the tragic death of 13-year-old Martha Mills, who died from sepsis in 2021 following a bicycle accident. A coroner found she would likely have survived if she had been transferred to intensive care at King’s College Hospital in London when her condition began to worsen. Her parents, Merope Mills and Paul Laity, subsequently campaigned for years to give families direct access to a rapid review helpline. Reflecting on the campaign’s milestones, Merope Mills is a senior editor at the Guardian, and the couple’s persistent advocacy drove politicians and NHS leaders to adopt the policy.
Impact and Growth of the Second Opinion Helpline
Since its initial introduction in English hospitals in 2024, the Martha’s rule framework has handled more than 10,000 calls during its first 16 months, potentially saving 446 lives, official figures show. These interventions allowed thousands of patients to be moved to intensive care units, receive necessary medications, or benefit from critical treatment changes. Furthermore, the initiative expanded to every maternity and neonatal unit in England in June, giving parents the right to seek a second opinion regarding maternal or newborn care.
Did you know? Demand for the Martha’s rule helpline reached its highest recorded monthly total in July, with 1,678 calls logged across participating facilities since the system’s inception.
Health leaders and officials have widely praised the ongoing expansion. Matthew Hopkins, acute and ambulance director at the NHS Alliance, noted that NHS leadership strongly supports giving patients and families the chance to be heard when conditions deteriorate. Health Minister Gillian Merron added that expanding the framework to A&E units gives everyone involved in patient care an additional mechanism to speak up and ensure urgent concerns receive immediate action.
Frequently Asked Questions
What is Martha’s rule?
Martha’s rule is an NHS patient safety initiative that allows patients, their families, and hospital staff to request an urgent review of care from a different medical team if a patient’s condition is deteriorating and concerns are not being addressed.
When will Martha’s rule be active in all A&E departments?
According to NHS England, a phased rollout across all emergency departments and waiting rooms in England is underway and will be fully completed by March 2028.
How many lives has the system potentially saved?
Official figures show that in the first 16 months following the introduction of the scheme in 2024, helplines received more than 10,000 calls, which potentially saved 446 lives.
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