Martha’s Rule: Saving Lives Through Patient-Led Care Reviews

A new initiative across England, known as Martha’s Rule, is empowering patients and their families to advocate for better care and is already showing promising results. Official figures suggest the system, which allows patients to request a rapid review of their condition if they are concerned it’s worsening, may have contributed to saving over 400 lives.

What is Martha’s Rule?

Martha’s Rule gives patients, their loved ones, and NHS staff the right to request a different medical team to examine the care being provided and recommend changes. This is particularly crucial when concerns about a deteriorating condition aren’t being adequately addressed. The initiative is named after Martha Mills, a 13-year-old who tragically died from sepsis in 2021 after a bicycle accident [NHS England].

The Impact So Far

Between September 2024 and December 2025, a total of 10,119 calls were made to Martha’s Rule helplines by patients, relatives, or staff expressing concerns about care [NHS England]. The impact of these calls has been significant:

• 446 patients received improvements to their care that may have been life-saving.
• 1,885 patients had their treatment changed as a direct result of the calls.
• 3,457 calls identified a rapid worsening of a patient’s condition, enabling quicker interventions.
• Approximately 6,000 calls addressed clinical, communication, or coordination concerns, leading to meaningful improvements in care and navigating the healthcare system.

The Story Behind Martha’s Rule

Martha’s Rule was developed in response to the death of Martha Mills and other cases where concerns about deteriorating patients were not adequately addressed. A coroner determined that Martha would likely have survived if she had been moved to intensive care earlier [NHS England]. Her parents, Merope Mills and Paul Laity, have been instrumental in advocating for the implementation of this rule across the NHS.

How Martha’s Rule Works

Patients at hospitals operating under Martha’s Rule have 24/7 access to a critical care team of doctors and nurses from elsewhere in the building. These specialists are equipped to assess deteriorating patients and recommend appropriate changes to care [NHS England].

National Rollout and Future Plans

Martha’s Rule is now in operation in every acute hospital in England [NHS England]. There are plans to expand the initiative to maternity departments, and calls are being made for its introduction in Wales and Scotland. The NHS Standard Contract 2026/27 requires NHS Trusts to implement the three core components of Martha’s Rule by March 31, 2027 [NHS England].

What Experts Are Saying

Aidan Fowler, NHS England’s director of patient safety, stated that Martha’s Rule is “already helping to save lives and transform the culture of the NHS.” Health Secretary Wes Streeting acknowledged the tireless campaigning of Merope Mills and Paul Laity, stating that they had turned “unimaginable grief” into “lasting change” [NHS England].

Merope Mills emphasized the positive impact of the rule, noting that over a third of the calls have led to a marked improvement in care and that the process is not being overused, indicating a genuine need for this type of patient advocacy.

Where to Identify More Information

For more information about Martha’s Rule, including accessible formats and translations, visit the NHS England website.