I would like to update the House on the Government’s commitment to implement Martha’s rule in England. Today we are announcing plans to implement Martha’s rule in at least 100 acute or specialist NHS sites in England by March 2025. Martha’s rule is an initiative that gives patients and their families who are concerned about deterioration in their physiological condition the right to initiate a rapid review of their case 24 hours a day from someone outside of their immediate care team.
Calls for Martha’s rule came following the tragic death of 13-year-old Martha Mills, who, after being admitted to hospital following an accident, contracted sepsis and deteriorated quickly.
Sadly, the signs of sepsis were not acted upon by doctors quickly enough, despite Martha’s family raising concerns with clinicians. Coroners found that Martha would probably have survived if doctors had identified the warning signs and transferred her to intensive care earlier.
I would like to pay tribute to Martha’s parents, Merope and Paul, who have worked tirelessly to raise awareness of what happened to Martha and to highlight the critical role that families play in recognising the signs of deterioration in their loved ones.
In September, the then Secretary of State for Health and Social Care, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), asked the Patient Safety Commissioner, Dr Henrietta Hughes, to rapidly lead work on how Martha’s rule could be implemented in England. I am grateful to Dr Hughes for her extensive engagement with system leaders and stakeholders, and for her recommendations on what Martha’s rule should look like.
While some NHS trusts already offer rapid review processes similar to Martha’s rule—called Call 4 Concern—others do not have an equivalent mechanism in place. In recognition of these variations in readiness, we are initiating a phased approach to implementing Martha’s rule.
The first phase will see Martha’s rule rolled out to at least 100 acute or specialist provider sites in England in 2024-25, supported by up to £10 million. NHS England will lead the process of identifying which acute provider sites will participate in this first phase and supporting the development of their local processes. Alongside this, drawing from the local learning from new and existing schemes, NHS England will develop proposals for national roll-out in the next spending review period.
This approach will enable significant progress to deliver Martha’s rule next year and to evaluate the additional resources needed for national roll-out.
I also look forward to working with the Patient Safety Commissioner, whom I have asked to chair a stakeholder oversight group jointly with NHS England and the DHSC. This group will build on the extensive engagement that has taken place over the last year, and will bring together patients, clinicians and external experts to provide ongoing advice to NHS England on the delivery of Martha’s rule.
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