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Martha's Rule

View profile for Amy Jones
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Martha Mills sadly died in 2021 after developing sepsis in hospital. Her family had raised concerns about her deteriorating condition, but these concerns were not responded to promptly.

At the inquest hearing in 2023, the coroner ruled that Martha’s death could have been preventable had her family's concerns been escalated and had she been moved to intensive care earlier.

As a result of campaigning by her parents, Martha’s Rule is being implemented in stages, beginning April 2024.

What is Martha’s Rule?  
Martha’s Rule gives patients in NHS hospitals in England, and their families and carers, the right to request a second opinion if they have concerns regarding the deterioration of the patient’s condition through the process of a rapid review by an independent critical care team.

Additionally, Martha’s Rule ensures that all staff in NHS trusts have access to the same rapid review process, and  a patient and their family must be consulted at least daily to obtain information about a patient’s condition. 

When will Martha’s Rule be introduced?
Martha’s Rule is set to be implemented at 100 NHS sites from April 2024. The procedure for requesting an opinion from the critical care outreach team will be advertised around the sites to make it readily accessible to NHS staff, patients, and their families and carers.  

This initial trial will be evaluated, and a standardised approach will be agreed prior to the expansion of the process across all NHS acute hospitals in the following years, subject to government funding.

What is the impact of Martha’s Rule on clinical negligence claims?
The aim of Martha’s Rule is to avoid preventable deaths by consulting with the families of patients regularly, thereby reducing clinical negligence claims.

Following a request being made for a patient to be reviewed by the critical care outreach team, this team assume a duty of care, the standard of which is equivalent to that of a responsible body of professional opinion in the same field as the treating clinicians.

If it is accepted that the Guidelines under Martha’s Rule is the recognised standard practice, then the failure to follow this practice could be a breach of duty.  Any breach of duty which is shown to cause injury or death could be subject to a clinical negligence claim.