Martha’s Rule: Giving families a voice when it matters most

Martha’s Rule is a patient safety initiative which gives families the right to request an urgent second opinion when they fear their loved one’s care is going wrong. It was brought into action following the death of 13-year-old Martha Mills, who sadly died of sepsis in hospital when her family’s concerns about her deteriorating condition were not responded to.

In 2023, a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier and as a result of this finding, and findings in other similar cases, Martha’s mother, Merope Mills, turned grief into action and campaigned for Martha’s Rule, which was implemented to allow families access to a second opinion if they feel they are not being listened to. 

Since its pilot launch in April 2024 across 143 hospital sites, the results have been striking with 4,906 calls made to Martha’s Rule helplines and 241 potentially life-saving interventions. A staggering 71.9% of calls came from families, proving that this initiative had empowered those closest to the patient to speak up. 

It has now been announced, on what would have been Martha’s 18th birthday, that Martha’s Rule has now been implemented in all 210 acute hospitals in England.

What does Martha's Rule offer?

Martha’s rule offers a dedicated helpline in hospitals for urgent second opinions. This allows:

• The ability for families and carers to raise concerns directly with a critical care team
• Daily insights from families recorded by clinicians to inform care
• Junior staff can escalate concerns to an independent team

This initiative is about changing the culture of care—making it more collaborative, respectful, and responsive and it has had a transformative effect to date. It is hope that with the roll out to further hospitals, even more lives will be saved. Health Secretary Wes Streeting praised the campaign and acknowledged similar issues in maternity services, where mothers’ concerns are often overlooked.

Gemma Bedford, Managing Associate, has said: “the expansion of Martha’s Rule marks a vital shift in patient safety and accountability. For too long, families have felt powerless when communicating concerns about their loved ones and this initiative provides a framework to be taken seriously before it’s too late.”