Martha’s Rule gives hospital patients, families and carers a way to raise urgent concerns if they feel a patient’s condition is getting worse and those concerns are not being recognised or acted upon.
Introduced across NHS hospitals in England, it aims to improve patient safety by ensuring that deterioration is identified and escalated quickly.
People who know the patient may be the first to notice changes that could be an early sign of deterioration. Find out more about Martha’s Rule.
We wanted to learn whether or not people were aware of Martha’s Rule and establish the best way it can be communicated to patients and families in Swindon.
115 people shared their feedback and experiences with us.
Key findings
- Awareness of Martha’s Rule remains limited, with many people unfamiliar with its purpose.
- There is strong support for the initiative, with 77% of respondents believing it can improve patient safety.
- People want information to be clear, accessible and available in multiple formats and settings.
- Many respondents confused Martha’s Rule with PALS, highlighting the need for clearer guidance about when to use each service.
Download our full report below.
Find out more
Raising awareness of Martha’s Rule is a shared responsibility. Patients, families, communities and local organisations all have an important role to play in helping people understand how and when to raise concerns about a patient’s deteriorating condition.
You can download our detailed poster about difference between Martha’s Rule and PALS, and our Easy Read guide to Martha’s Rule below.
In response to our report, Luisa Goddard, Chief Nurse, The Great Western Hospital, said:
Great Western Hospitals NHS Foundation Trust welcomes the Healthwatch findings and the valuable feedback provided by patients, families and carers.
We are pleased the report recognises the positive impact of Martha’s Rule and the commitment of our staff to ensuring concerns are heard and acted upon. We acknowledge the recommendation to increase awareness of the service and have already identified actions to strengthen promotion, accessibility and understanding of Martha’s Rule across our organisation.
We remain fully committed to ensuring patients, families and carers feel empowered to raise concerns and seek a rapid clinical review when needed. We will continue to work with Healthwatch and our partners to support ongoing improvement and provide the safest possible care.
Further resources
The links below will help you learn more about Martha’s Rule, access implementation resources and see how the initiative is improving patient safety across the NHS:
- New animated explainer launched to promote Martha’s Rule – Health Innovation West of England – Martha’s Rule in the West of England | Videos & Movies on Vimeo
- New e-learning helps NHS staff implement Martha’s Rule – Health Innovation West of England
- NHS England » Martha’s Rule
Martha’s story
Martha Mills died in 2021 after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling off her bike. Martha’s family’s concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that Martha, aged 13, would probably have survived had she been moved to intensive care earlier.
In response to this and other cases related to the management of clinical deterioration, the then Secretary of State for Health and Social Care and NHS England committed to implement ‘Martha’s Rule’ across the NHS.