NHS England Adopts Martha’s Rule After 5,000 Calls and Life-Saving Interventions

Martha’s Rule Expanded Across All Acute Hospitals in England After Saving Hundreds of Lives

Martha’s Rule — a system allowing patients and families to request an urgent review of care when concerns are not being taken seriously — is now being introduced across every acute hospital in England.

The initiative was born from the tragic death of 13-year-old Martha Mills, who died from sepsis at King’s College Hospital, London, after her parents’ repeated warnings about her worsening condition were not acted upon. In 2022, a coroner concluded that Martha would likely have survived had she been transferred to intensive care sooner and given appropriate treatment.

From Pilot to Nationwide Rollout
The rule was first piloted in April 2024 across 143 hospital sites in England. Families could call a dedicated telephone helpline to escalate concerns directly to a critical care team, independent of the patient’s immediate ward staff.

Since then, NHS England data shows there have been nearly 5,000 calls, resulting in 241 cases where interventions may have saved lives. The pilot also demonstrated wider benefits:

• 720 cases where new medications, including antibiotics, were started
  
  
• 794 cases where delays in tests or treatments were resolved
  
  
• 1,030 cases where communication problems, including discharge planning, were addressed
  

A Parent-Led Campaign
The push for this initiative came from Martha’s parents, Merope and Paul Mills, who have campaigned tirelessly to make the health service more responsive to families’ concerns.

On what would have been Martha’s 18th birthday, Merope Mills welcomed the full rollout:

“The evidence shows Martha’s Rule is already saving lives. But more than that, it is encouraging a fairer, more equal relationship between patients, families, and clinicians.”

She also called for the scheme to be made available across the entire UK, not just in England, and emphasized its importance in maternity care, where mothers’ concerns are still too often dismissed.

How Martha’s Rule Works
The principle is simple but powerful:

• Families, carers, or patients can raise urgent concerns through a direct helpline.
  
  
• A critical care outreach team, separate from the patient’s ward staff, reviews the situation promptly.
  
  
• Junior staff are also empowered to request an urgent review if they feel something is being missed.
  
  
• Families’ daily observations and insights are formally recorded alongside medical notes, ensuring their voices are included in decision-making.
  

Voices from the NHS and Beyond
Health Secretary Wes Streeting praised the scheme, thanking the Mills family for their determination and acknowledging NHS staff for embracing the change.

He noted that similar patterns of patients not being listened to are also seen in maternity services, stressing the importance of a culture shift where every voice counts:

“Listening to patients — and especially to women — is essential. Responding at the right time, in the right place, can prevent harm and, in the worst cases, save lives.”

During an interview on BBC Radio 4, Merope Mills shared a message from a listener who believed a child’s life in their family had been saved thanks to the helpline:

“I followed Martha’s story, never imagining my family would need Martha’s Rule. Thank you for raising awareness and giving people the courage to speak up.”

Why This Matters
Martha’s Rule represents more than just a helpline — it’s a cultural change in how the NHS approaches patient safety and communication. By formalizing families’ right to be heard, it reduces the risk of fatal oversights and creates accountability across all levels of care.

As Merope Mills reflected:

“The reality is that any of us could find ourselves in this situation. It could be your parent, your sibling, or your child who needs this safeguard one day.”

With nationwide implementation now in place, thousands more families across England will have access to this vital safety net — and the campaign continues for UK-wide adoption.