A MAJOR rule change to allow patients a right to second medical opinion to be tested and rolled out in 143 hospitals.
Named after teenage Martha Mills, who died of sepsis despite her parents’ pleas that she wasn’t receiving the necessary care, the rule will see give patients and their families access to a rapid review if they are worried about their condition.
PAMartha Mills, 13, died from sepsis in 2021 after medics failed to heed her parents’ warnings about her rapidly deteriorating condition[/caption]
NHS England pledged to introduce ‘Martha’s Rule’ to at least 100 hospitals in February.
But it announced today that 143 sites will roll out the rule change by March 2025 – surpassing the initial target – following “significant interest” from hospitals across the country.
The purpose of Martha’s Rule is to provide “a consistent and understandable way for patients and families to seek an urgent review if their or their loved one’s condition deteriorates and they are concerned this is not being responded to”, NHSE said.
It’s now working with Martha’s parents to develop materials to advertise and explain the initiative in hospitals across the country, so patients, their families and staff know when to call for a second opinion.
Martha Mills, 13 , died from sepsis in 2021 after medics at King’s College Hospital, London, failed to boost her intensive care despite her parents raising concerns about her rapidly deteriorating condition.
Her parents Merope Mills and Paul Laity said: “We are pleased that the roll-out of Martha’s Rule is off to a flying start and that the need for it has been so widely recognised.
“It will save lives and encourage better, more open, communication on hospital wards, so that patients feel they are listened to, and partners in their healthcare.”
HOW WILL THE ‘3-STEP SAFETY NET’ WORK?
NHSE was initially aiming to implement the rule change in at least 100 hospitals.
But “significant interest from frontline clinicians” had lead to the first phase of the programme being expanded.
By March 2025, patients and their families will be able to request an urgent review into their or their loved one’s care in 143 locations across the country.
Each hospital will evaluate whether the system works over the course of this year.
Martha’s Rule could then be further expanded across all acute hospitals in England, subject to future government funding.
The rule will be made up of three components so that concerns about deterioration can be swiftly responded to.
Firstly, an escalation process will be available 24/7 at all the 143 sites.
This will be advertised throughout the hospitals on posters and leaflets, enabling patients and families to contact a critical care outreach team that can swiftly assess a case and escalate care if necessary.
Secondly, NHS staff will also have access to this same process if they have concerns about a patient’s condition.
Finally, clinicians at participating hospitals will also be obligated to formally record insights and information about a patient’s health provided by their families daily.
This will ensure that any concerning changes in behaviour or condition noticed by the people who know the patient best are considered by staff, NHSE said.
‘MOST IMPORTANT CHANGE TO PATIENT CARE IN YEARS’
Martha’s parents Merope and Paul campaigned extensively for a single system that allows patients or their families to trigger an urgent clinical review from a different team in the hospital if the patient’s condition is rapidly worsening and they feel they are not getting the care they need.
They were supported by the cross-party think tank Demos.
Their campaigning saw widespread support from hospitals and clinicians.
Professor Sir Stephen Powis, NHS national medical director, said: “Rolling out Martha’s Rule to over 143 NHS sites in this first phase will represent one of the most important changes to patient care in recent years, and we are pleased to have seen such interest from hospitals right across the country, all thanks to the moving and dedicated campaigning by Martha’ parents, Merope and Paul.
“That is why today is such an important milestone, with the NHS outlining the 143 sites where this major patient safety initiative will be rolled out later this year, allowing staff, patients and families to immediately raise concerns and bring about an escalation in care in an easily recognisable and fast way.
“The inclusion of daily insights from families about their loved ones’ condition within patient records is also a really significant step and will help staff identify changes and deterioration using insights from those who know the patient best.
“While thankfully the need for escalation of care will hopefully only be needed in a limited number of cases, this three-step safety net has the opportunity to truly transform patient care and safety.”
What are the symptoms of sepsis?
SEPSIS is a life-threatening reaction to an infection that happens when your immune system overreacts and starts to damage your body’s own tissues and organs.
Symptoms of sepsis in an adult include:
Acting confused, slurred speech or not making sense
Blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
A rash that does not fade when you roll a glass over it, the same as meningitis
Difficulty breathing, breathlessness or breathing very fast
Symptoms in a child include:
Blue, grey, pale or blotchy skin, lips or tongue – on brown or black skin, this may be easier to see on the palms of the hands or soles of the feet
A rash that does not fade when you roll a glass over it, the same as meningitis
Difficulty breathing (you may notice grunting noises or their stomach sucking under their ribcage), breathlessness or breathing very fast
A weak, high-pitched cry that’s not like their normal cry
Not responding like they normally do, or not interested in feeding or normal activities
Being sleepier than normal or having difficulty waking
They may not have all these symptoms.
If you think you or someone else has symptoms of sepsis, call 999 or go to A&E.
Source: NHS
NHS national patient safety director and senior responsible officer for Martha’s Rule, Dr Aidan Fowler, added: “Working closely with Martha’s parents and colleagues across the NHS over the last few months on this rollout, I am in no doubt this programme will deliver clear change.
“It has been so encouraging to see how many hospitals have shown interest in being part of delivering these all-important patient safety measures this year.
He said the new processes brought about by Martha’s rule “can help us better identify and manage deterioration as part of wider work, which is a key priority for us and will no doubt lead to improvements in the care patients receive”.
The parents of young rugby star Maddy Lawrence recently expressed their support of Martha’s Rule, after their 20-year-old daughter died in hospital from sepsis.
Maddy’s “screams of pain” weren’t listened to by medics until it was too late and she was branded a “difficult patient”.
WHICH HOSPITALS ARE ROLLING OUT MARTHA’S RULE?
NHS provided the full list of hospitals rolling out the rule change:
Addenbrooke’s Hospital
Watford General Hospital
Princess Alexandra Hospital
Colchester Hospital
Bedford Hospital
Southend Hospital
Basildon Hospital
Broomfield Hospital
Peterborough City Hospital
Lister Hospital
West Suffolk Hospital
Luton and Dunstable University Hospital.
James Paget University Hospital
The Queen Elizabeth Hospital
Norwich University Hospital
Ipswich Hospital
University Hospital Lewisham
The Royal Marsden Hospital , Chelsea
The Royal Marsden Hospital, Sutton
Croydon University Hospital
St Georges Hospital
Barnet Hospital
Royal Free Hospital
Great Ormond Street Hospital for Children
North Middlesex University Hospital
University College Hospital
Kingston Hospital
Kings College Hospital (Denmark Hill Site)
Queen Elizabeth Hospital
Princess Royal University Hospital
Chelsea and Westminster Hospital
West Middlesex University Hospital
Northwick Park Hospital
Charing Cross Hospital
Hillingdon Hospital
St. Mary’s Hospital
Hammersmith Hospital
Newham University Hospital
Homerton University Hospital
St Bartholomew’s Hospital
Whipps Cross Hospital
Royal London Hospital
The Whittington Hospital
Ealing Hospital
Northampton General Hospital
Kettering General Hospital
Royal Stoke University Hospital
New Cross Hospital
Manor Hospital
Pilgrim Hospital Boston
Birmingham Heartlands Hospital
Good Hope Hospital
Queen Elizabeth Hospital
Solihull Hospital
Birmingham Children’s Hospital
Russell’s Hall Hospital
Sandwell General Hospital and City Hospital (two sites)
Glenfield Hospital
Kings Mill Hospital
Kettering General Hospital
University Hospital Coventry
Lincoln County Hospital
Leicester Royal Infirmary
Leicester General Hospital
Robert Jones and Agnes Hunt Orthopaedic Hospital
Sheffield Childrens Hospital
Barnsley Hospital
Queen Elizabeth Hospital
Site: Sunderland Royal Hospital
Site: South Tyneside District General Hospital
Huddersfield Royal Infirmary
York Hospital
Cumberland Infirmary
University Hospital of North Durham
Bishop Auckland Hospital
Royal Victoria Infirmary, Newcastle
Freeman Hospital
James Cook University Hospital
Darlington Memorial Hospital
West Cumberland Hospital
Pinderfields Hospital
Calderdale Royal Hospital
Leeds General Infirmary
Bradford Royal Infirmary
Airedale General Hospital
St James’s Hospital
Countess of Chester Hospital
Wirral University Teaching Hospital
Royal Liverpool University
Southport District General Hospital
Blackpool Victoria Hospital
Royal Blackburn Hospital
Burnley General Hospital
Royal Bolton Hospital
Royal Manchester Children’s Hospital
Alder Hey Childrens Hospital
The Walton Centre
Leighton Hospital
Warrington Hospital
Preston and Chorley Hospitals
Royal Blackburn Hospital
Tameside General Hospital
The Christie
Royal Oldham Hospital
Royal Albert Edward Infirmary, Wigan
St Mary’s Hospital
Frimley Park Hospital
Wexham Park hospital site
Darent Valley Hospital
The Tunbridge Wells Hospital
Maidstone Hospital
Southampton Children’s Hospital
Royal Berkshire Hospital
Stoke Mandeville Hospital
Conquest Hospital
Eastbourne District General Hospital
Royal Sussex County Hospital
Princess Royal Hospital
Medway Maritime Hospital
William Harvey Hospital, Ashford
QEQM Hospital, Margate
Queen Alexandra Hospital
Basingstoke North Hampshire Hospital
East Surrey Hospital
Southampton General Hospital
Bristol Royal Infirmary
Great Western Hospital
Salisbury District Hospital
Cheltenham General Hospital
Gloucestershire Royal Hospital
Dorset County Hospital
Royal Bournemouth Hospital
Poole Hospital
Torbay Hospital
Derriford Hospital
Musgrove Park Hospital
Yeovil District Hospital
Weston General Hospital
Southmead Hospital
Bristol Royal Hospital for Children
Royal United Hospital, Bath
Treliske Site – Royal Cornwall Hospital