Following a successful pilot scheme, Martha’s Rule has been extended across all of England’s acute NHS hospitals as of the 4th of September 2025.
The Success of Martha’s Rule and extension of the Scheme
After extensive campaigning by her family, Martha’s Rule was originally piloted in April 2024 across 143 NHS hospitals across England.
The scheme has been hailed as ‘transformative’ by Professor Meghana Pandit, NHS National Medical Director. According to NHS England, 4,906 requests were made between September 2024 and June 2025. These led to 241 potentially life-saving interventions and 720 changes to care plans. Martha’s Rule has empowered patients and their families to actively engage in their own care and are ensured their concerns will be treated seriously.
As a result of the scheme’s success, Martha’s Rule has now been extended across all of England’s acute NHS hospitals as of the 4th of September 2025.
What is Martha’s Rule?
Martha’s Rule allows patients in NHS hospitals in England, and their families or carers, to request a second opinion when they are concerned about a patient’s deteriorating condition. An independent critical care team conducts a rapid review, evaluating the care provided and suggesting improvements where needed. NHS staff can also request a review if they are concerned about the care of any patient
In addition, patients and their families must be consulted daily to obtain information about a patient’s condition.
Why was Martha’s Rule introduced?
Martha’s Rule was introduced following the tragic death of 13-year-old Martha Mills in 2021. Martha sustained a pancreatic injury after a cycling accident and was admitted to King’s College Hospital in London. While under care, she developed sepsis. Her family repeatedly raised concerns about her worsening condition, but unfortunately, those concerns were not acted upon.
An inquest later found that Martha’s death from sepsis was preventable had she been moved to an intensive care unit earlier. Her parents, Merope Mills and Paul Laity, campaigned tirelessly to ensure that no other family would be ignored in similar circumstances. Their efforts led to the creation of Martha’s Rule.
Implications for Clinical Negligence Claims
In clinical negligence claims, healthcare professionals must meet the standards expected by a responsible body of professionals in the same field as the treating clinicians.
Martha’s Rule is now the expected standard across all NHS acute hospitals in England. Therefore, if a hospital fails to act on a request for a second opinion and harm results from that failure, there may be grounds for a clinical negligence claim.
Martha’s Rule promotes collaboration between medical professionals and patients, an issue that also affects providers of acute private healthcare. Private healthcare providers are not required to implement Martha’s Rule. However, if Martha’s Rule becomes the expected standard among reasonable clinicians in the same field, failing to act on a second opinion request might lead to a clinical negligence claim. That said whether Martha’s Rule becomes a legal expectation across private healthcare settings remains to be seen.
Ultimately, the aim of Martha’s rule is to prevent avoidable deaths through greater collaboration with patients and their families.
If you are struggling with any of the issues raised in this article and wish to seek advice from a legal professional, please get in touch with a member of our Personal Injury team.