Rule helplines receive over 1,700 calls from concerned NHS staff
Martha’s Rule helplines receive significant use from NHS staff in England, with more than 1,700 calls made to flag concerns about patient care. The helplines were established following a campaign by the family of Martha Mills, a 13-year-old girl who died due to serious failings in her treatment at King’s College Hospital in London.
Purpose and impact of Martha’s Rule helplines
The scheme encourages NHS staff, patients, and families to seek an urgent second opinion if they fear a patient’s condition is worsening and their concerns are not being addressed. It also allows clinicians to record daily insights about a patient’s health directly from families. Staff members, including those in junior roles, can request a review from a team independent of their usual care team.
Since their introduction in September 2024, the helplines have been available at 143 hospital sites across England. Between then and February, nearly 1,800 calls were made by staff. NHS England reports that over 1,000 of these calls helped identify serious deterioration in patients’ conditions.
Outcomes and expansion of the scheme
Aidan Fowler, National Director of Patient Safety at NHS England, highlighted that while not every call directly saved a life, the scheme has proven valuable. More than 500 patients were transferred to intensive care following calls, and approximately 1,500 patients experienced changes in their care, such as receiving timely antibiotics or fluids on the ward. These interventions have the potential to improve outcomes and save lives.
The NHS is expanding Martha’s Rule to cover adult and child wards, with plans to extend the initiative to maternity, neonatal, and emergency departments.
Family perspective and staff experience
Merope Mills, Martha’s mother, spoke about the importance of the helplines on BBC Radio 4’s Today programme. She noted that the helpline provides a “non-confrontational” way for staff to raise concerns, which is important given the hierarchical nature of medicine. Mills mentioned a particular nurse who might have used the helpline if it had been available during Martha’s treatment.
Martha Mills died from sepsis in 2021 after her family’s concerns were not adequately addressed. In 2022, a coroner ruled that Martha would probably have survived if she had been transferred earlier to intensive care and received appropriate treatment.
Martha’s Rule aims to prevent similar tragedies by empowering staff and families to speak up and seek urgent reviews when a patient’s condition deteriorates.