Martha’s Rule Now Fully Implemented Across All Acute Hospitals in England

Published: 04 September 2025 | The English Chronicle Desk

A landmark patient safety initiative, known as Martha’s rule, is now in operation in every acute hospital across England, NHS leaders confirmed on Thursday. The system, which empowers patients and their families to request an independent review of medical care if they fear their concerns are being overlooked, has already been credited with saving hundreds of lives since its phased rollout began last year.

Martha’s rule takes its name from 13-year-old Martha Mills, who tragically died in 2021 after developing sepsis following a bicycle accident. A coroner later concluded that Martha would probably have survived if she had been moved to intensive care at King’s College Hospital in London when her condition first began to deteriorate. Her death, deemed preventable, spurred her parents, journalist Merope Mills and writer Paul Laity, to campaign for systemic change within the NHS. On what would have been her 18th birthday, health officials confirmed that the rule named in her memory has now been adopted across all 210 acute hospitals in England.

The rule allows patients, their relatives, or NHS staff to demand a second opinion from an alternative medical team if they are concerned that someone’s care is inadequate. In practice, it has meant patients being transferred urgently to intensive care, administered antibiotics, or given other crucial interventions that doctors had not previously provided. According to NHS data, helplines established under the initiative received nearly 5,000 calls between September 2024 and June 2025. As a result, 241 patients were given enhanced care that officials say may have been life-saving.

Professor Meghana Pandit, NHS England’s national medical director, described the measure as “a transformative impact” on the way hospitals listen and respond to patients. “Martha’s rule ensures that families’ voices are not only heard but acted upon, especially at moments when rapid intervention can make the difference between life and death,” she said.

For Martha’s parents, the widespread adoption of the rule is bittersweet. “It would be Martha’s 18th birthday today, another milestone she has missed as a result of the poor care and hospital errors that led to her unnecessary death,” they said in a statement. “We feel her absence every day. But at least Martha’s rule is already preventing many families from experiencing something similar. The figures prove that lives are saved when patients and families are given power to act on their suspicions when they feel doctors might have got it wrong and their voice isn’t being heard.”

Health Secretary Wes Streeting paid tribute to Martha’s parents for what he called their “tireless campaigning,” crediting them with creating “a lasting legacy that is already having a potentially life-saving impact across England.” Rachel Power, chief executive of the Patients Association, hailed the implementation of the rule in every acute hospital as “a landmark moment for patient safety.”

The data reveal that parents are the most frequent users of the scheme, making up nearly three-quarters of all calls. Hospitals that pioneered the rollout, such as Walsall Manor, have also extended Martha’s rule into children’s services. Amy Blakemore, a matron in its sepsis and outreach response team, said families were now seen as “a vital part of the care and treatment decisions that are made for the children and young people in our hospital.” She added: “Any concerns in relation to their child’s deteriorating condition that they feel are not being listened to can initiate Martha’s rule and they can get an independent review.”

For many, Martha’s rule is not just a reform but a cultural shift within the NHS, recognising the indispensable role of patients and families in safeguarding care. Campaigners hope the model will eventually extend beyond England to the rest of the UK, ensuring that Martha’s legacy continues to shape a more accountable and responsive health service.