Martha's Rule

[2][3] Martha's Rule is also a 'cultural intervention', which will help to flatten hierarchies within medicine, improve listening and openness on the part of clinicians and give patients and their families greater agency.

[11] She recounted that Martha developed severe sepsis six days before she died, one symptom of which was that she bled copiously from the tubes in her arms and stomach.

Mills expressly voiced her fear that Martha would die of septic shock over the bank holiday weekend, when the consultants 'weren't around'.

'[4] Following the significant public response to the Guardian article, Mills and Laity were asked by the think-tank Demos to work jointly on a patient safety initiative designed to learn from Martha's death.

[1] In September 2023, the then Secretary of State for Health and Social Care, Steve Barclay, asked Henrietta Hughes, the Patient Safety Commissioner, to work on an implementation plan for Martha's Rule.

After four 'sprint' meetings involving NHS Trusts, the Health Ombudsman, the Care Quality Commission, the General Medical Council, the Patients Association and other bodies, Hughes submitted her recommendations to the Secretary of State on 20 October 2023.

[26] On 21 February 2024, NHS England and the Department of Health announced that the roll-out of Martha's Rule would begin with 100 hospitals from April 2024 to March 2025.

According to Victoria Atkins, the Secretary of State for Health, the 'introduction of Martha's Rule from April will put families at the heart of the patient's own care, recognising the critical role they have in the treatment of loved ones'.

[28] The organisations stated that 'Martha's Rule reinforces the fundamental principles of listening to people who use health and care services and their families, and acting on what they say.

'[28] Mills has argued that Martha's Rule will not only save lives but bring about a significant shift in the culture within hospitals towards patient power.

But Dr Vishal Sharma, chair of the BMA's consultants committee, argued that 'it is essential that the current workforce crisis is addressed so that critical care outreach teams have the necessary staff they need to deliver this initiative.

[2] But a broad survey of evidence shows that initiatives such as Martha's Rule always improve communication; they are not overused or abused by patients or families, and result in necessary escalations which would otherwise not have occurred.

[34] The initial implementation target was to enrol at least 100 sites, but due to significant interest from frontline clinicians this has been expanded, so that the first phase of the Martha's Rule programme will be in place at 143 locations across England by March 2025.