Pharmacist Raj Patel, known as the Straight-Talking Pharmacist on TikTok, has highlighted two words that could help families get heard in A&E if a loved one's condition is deteriorating. In a recent video, he said: "If you're sitting in A&E and someone you love is getting worse, these two words could help you get heard."
The words are "Martha's Rule," a patient safety initiative that allows patients, relatives and carers to request an urgent review by a different clinical team if they are worried someone's condition is worsening and feel their concerns are not being acted upon.
What Martha's Rule Is and Isn't
Mr Patel, who has more than 100,000 followers on TikTok, explained: "But let me be clear, it isn't a way to jump the queue or complain about the waiting time. It's specifically for somebody whose condition is drastically getting worse."
The initiative is not a means to obtain a faster assessment simply because of a long wait. Average A&E waiting times across the NHS sit at roughly 2 to 3 hours.
Background and How to Use It
Martha's Rule was introduced following the death of 13-year-old Martha Mills, who developed sepsis in hospital in 2021 after being admitted with a pancreatic injury. A coroner later concluded that she would probably have survived had she been transferred to intensive care earlier, after her family's concerns about her deteriorating condition were not acted upon.
Mr Patel urged people to explain exactly what has changed rather than simply telling staff that someone seems worse. He said: "So if your loved one suddenly becomes sleepier, confused or breathless or dramatically different, don't just say they're worse. Explain what has changed when it started and say, I'm worried they're deteriorating or getting worse."
Implementation and Next Steps
NHS England says Martha's Rule is being implemented across acute inpatient services in England, with full implementation expected during 2026/27. Emergency departments are among the additional settings where the approach is being tested, but it is not yet generally available in A&E, so patients and relatives should check with staff at their hospital.
The NHS initiative has already prompted changes to patient care, including urgent interventions and transfers to higher levels of care. Anyone concerned about a deteriorating patient should alert staff immediately, explain the changes they have noticed and ask how to request an urgent review if they feel their concerns are not being addressed.
