Every A&E in England to introduce Martha’s Rule by 2028

Martha’s Rule will be introduced across every A&E department in England, giving patients, relatives and NHS staff another route to request an urgent review when they believe somebody’s condition is deteriorating.

Each emergency department will provide a dedicated telephone number that can be used when concerns about a patient are not being heard. A separate clinical team will then review the person’s condition and recommend any necessary changes to their care.

The phased rollout begins this month and is expected to reach every A&E, including waiting rooms, by March 2028.

The expansion follows an eight-month pilot involving seven NHS trusts. Sixty-nine calls were made during the trial, with some patients subsequently undergoing urgent surgery or being transferred to intensive care.

Martha’s Rule was created following the death of 13-year-old Martha Mills from sepsis in 2021. A coroner concluded that she would probably have survived if doctors at King’s College Hospital had acted on her parents’ concerns and transferred her to intensive care sooner.

More than 10,000 calls were made through Martha’s Rule during its first 16 months on inpatient wards, leading to 446 changes in care considered potentially life-saving. These included transfers to intensive care, urgent operations and the administration of essential medicines.

The rule has also been extended to maternity and neonatal services, allowing women and families to request a rapid second opinion when they are worried about the condition of a mother or baby.

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