An NHS GP has explained what a new rule coming to all A&E departments in England means for patients. Dr Arshad Rizvi, based in London, said the rule is something "all patients and families should know about."
What is Martha's Rule?
"It's called Martha's Rule and it was introduced after the tragic case of 13-year-old Martha Mills, who died from sepsis in 2021 after her family had raised concerns that she was getting worse," he explained in a TikTok video.
"If you're worried you or someone you care for is getting worse, you should tell the medical team," Dr Rizvi continued. "But if you're still worried and feel your concerns aren't being responded to - Martha's rule allows you to call a dedicated number and request a rapid review from a different clinical team."
In addition, NHS staff can also request a review if they are concerned about a patient deteriorating.
Expansion and impact
"Between September 2024 and June 2026, there were 17,490 Martha's Rule calls and that resulted in over 3,000 changes to treatment," Dr Rizvi said. "And now the rule is being expanded into A&E departments including waiting rooms across England."
The rollout will be happening in phases. "Remember the name," the GP closed. "It's another way patients and families can be heard when someone's condition is worsening."
Core components and how to use it
According to NHS England, the three core components of Martha's Rule are: patients will be asked at least daily about how they are feeling, and if they are getting better or worse, and this information will be acted on in a structured way; all staff will be able at any time to ask for a review from a different team if they are concerned that a patient is deteriorating and they are not being responded to; and this escalation route will always be available to patients themselves, their families and carers and advertised across the hospital.
Martha's Rule is not a second opinion. A second opinion is an already established process where patients, families or carers can choose to see another healthcare professional after they've been given a diagnosis or treatment plan for a medical condition.
There is not one single Martha's Rule phone number. Each hospital has its own dedicated phone number for patients, families and staff to call to request a rapid review when they are concerned a patient's condition is deteriorating. You should look for the specific Martha's Rule contact number for the hospital where the patient is admitted by checking the hospital's website for Martha's Rule information, looking for posters about Martha's Rule displayed in the hospital, or asking hospital staff. If you are unsure whether Martha's Rule is available at your hospital, ward or unit, check the trust's website or ask staff. For more information, visit NHS England's dedicated page.
