Martha’s Rule to give NHS patients and families right to urgent second opinion

Patients and their families can request a rapid second opinion from April if they are worried about a condition getting worse, as the NHS rolls out Martha’s Rule in England.

The escalation process will instigate an urgent review by a different critical care team in the hospital and will be available 24/7.

It can be used if a patient’s condition is rapidly worsening and they or their family feels they are not getting the care needed.

The new process follows the death of 13-year-old Martha Mills in 2021, who developed sepsis under the care of King’s College Hospital NHS Foundation Trust in London.

Her parents – who campaigned for the change – said they want it “in place as quickly and widely as possible”, with at least 100 NHS trusts expected to bring in the rule initially.

“We believe Martha’s Rule will save lives,” Merope Mills and her husband Paul Laity said in a statement.

“In cases of deterioration, families and carers by the bedside can be aware of changes busy clinicians can’t; their knowledge should be recognised as a resource.

“We also look to Martha’s Rule to alter medical culture: to give patients a little more power, to encourage listening on the part of medical professionals, and to normalise the idea that even the grandest of doctors should welcome being challenged.”

Martha was being treated after suffering a pancreatic injury in a fall from her bike during a holiday in Wales.

An inquest heard there were several missed opportunities to refer her to intensive care, and that she probably would have survived if doctors had identified sooner that she was rapidly getting worse.

At one point, Martha began to bleed heavily through a tube inserted into her arm and through a drainage tube, and she also developed a rash.

Her mother voiced concerns to staff that her daughter would go into septic shock over the bank holiday weekend.

One of the trust’s own intensive care doctors told the inquest he would “100%” have admitted her if he had seen her.

The trust – a specialist referral centre for children with pancreatic problems – has apologised.

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The plan is to extend Martha’s Rule to all acute hospitals, subject to government funding, with the programme evaluated throughout this year and next.

NHS chief executive Amanda Pritchard said it had the potential to “save many lives in the future”, while Health Secretary Victoria Atkins said it would “provide a major boost to patient safety”.

“The introduction of Martha’s Rule from April will put families at the heart of the patient’s own care, recognising the critical role they have in the treatment of loved ones,” said Ms Atkins.

Martha’s parents said their daughter’s death was “a preventable death but Martha’s Rule will mean that she didn’t die completely in vain”.

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