A new scheme that will allow worried families and patients to seek a rapid second opinion on their care is being rolled out to every acute hospital in England.
Martha’s rule was set up after the death of 13-year-old Martha Mills, who developed sepsis while under the care of King’s College Hospital NHS Foundation Trust in south London in 2021.
A coroner ruled she would most likely have survived if doctors had identified the warning signs of her rapidly deteriorating condition sooner and transferred her to intensive care.
Her parents, Merope Mills – an editor at The Guardian – and Paul Laity, raised concerns about Martha’s health a number of times, but were repeatedly ignored.
At one point, Martha began to bleed heavily through a tube inserted into her arm and through a drainage tube.
Her mother voiced concerns to staff that her daughter would go into septic shock, and one of the trust’s own intensive care doctors told the inquest he would “100%” have admitted her if he had seen her.
Urgent reviews of care
The new escalation process, which formalises access to a critical care team for a second opinion, is available 24/7 and advertised throughout hospitals.
Under the rule, a patient or their family can request an urgent clinical review is carried out by a different team in the hospital if a patient’s condition is worsening. Staff can also ask for a review from a different team.
Between September 2024 and June 2025, some 4,906 calls were made to Martha’s rule helplines to escalate concerns about care, NHS England said.
Almost three-quarters (72%) of these calls were from families seeking help. A total of 720 of the calls led to changes in care, such as new medicines and antibiotics.
Almost 800 led to clinical concerns, such as medication or investigation delays, being addressed.
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The campaign was first rolled out to 143 pilot sites in May 2023.
Now, all 210 acute inpatient sites in England will offer the service, NHS England said.
Announced on Martha’s birthday
Ms Mills and Mr Laity said in a statement: “It would be Martha’s 18th birthday today, another milestone she has missed as a result of the poor care and hospital errors that led to her unnecessary death.
“We feel her absence every day, but at least Martha’s rule is already preventing many families from experiencing something similar.
“The figures prove that lives are saved when patients and families are given power to act on their suspicions when they feel doctors might have got it wrong and their voice isn’t being heard.
“We are pleased to know more hospitals are taking up Martha’s rule and look forward to a time when every patient in the UK knows about the initiative, and has easy access to it.”
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Health Secretary Wes Streeting said: “No family should ever have to go through what Merope and Paul Mills endured when they lost Martha, but her parents’ tireless campaigning has created a lasting legacy that is already having a potentially lifesaving impact across England.
“Martha’s rule puts patients and families at the heart of their care. By rolling this out to every acute hospital in England, we’re delivering on our promise through our plan for change to rebuild trust in the NHS and put patient safety first.”
