'Martha's Rule' now in operation at all NHS acute hospitals
The rule is named after Martha Mills, who died in 2021 at the age of 13 from sepsis after a bicycle accident. A coroner found she would probably have survived if she had been moved to the intensive care unit at King’s College hospital in London when she began deteriorating.
Martha’s Rule recognises that those who know the patient best may be the first to notice changes that could be an early sign of deterioration, and the importance of listening to and acting on the concerns of patients, families, and carers. It is being implemented in both adult and children’s inpatient settings in England.
Early evidence from the pilot sites suggests Martha’s Rule is saving lives. Data from September 2024 to June 2025 shows 4,906 Martha’s Rule calls were made, with the highest proportion of calls (71.9%) made via the family escalation process. 2,132 Martha’s Rule escalation calls (43%) related to acute deterioration. Of those, 241 calls resulted in potentially life-saving escalations of care, including:
- 93 urgent admissions to high dependency or intensive care units
- 49 resulting in transfers to another enhanced level of care or to a tertiary centre.
