A new regulation is set to be implemented across all acute medical facilities in England following the tragic passing of a 13-year-old girl. Known as Martha’s rule, this initiative aims to provide families and patients with expedited access to a second medical opinion. The rule stems from the case of Martha Mills, who developed sepsis while under the care of King’s College Hospital NHS Foundation Trust in south London in 2021.
An official inquiry concluded that Martha could have likely survived if healthcare professionals had promptly recognized the signs of her deteriorating health and transferred her to intensive care earlier. Martha’s parents, Merope Mills and Paul Laity, expressed their concerns regarding Martha’s well-being multiple times, but their worries were disregarded.
The escalation process, which formalizes the procedure for seeking a second opinion from experienced medical personnel, particularly critical care outreach teams, is now accessible 24/7 and promoted across hospitals in England. Under this protocol, if a patient’s condition worsens and they or their family feel dissatisfied with the care provided, an urgent clinical review by a different hospital team is initiated.
Moreover, staff members are encouraged to request a review from another team if they have apprehensions about a patient’s treatment. Between September 2024 and June 2025, there were 4,906 calls made to Martha’s rule helplines to report concerns about care, according to NHS England.
Nearly 72% of these calls were made by families seeking assistance, with 720 resulting in changes to the care plan, such as the introduction of new medications and antibiotics. Additionally, 794 calls prompted interventions to address clinical issues like delays in medication or testing. Furthermore, 1,030 calls led to improvements in communication and discharge planning procedures. NHS England confirmed that all 210 acute inpatient facilities in England now offer this service.
In a joint statement, Ms. Mills and Mr. Laity expressed their sorrow over Martha’s untimely death and highlighted the positive impact of Martha’s rule in preventing similar tragedies for other families. They emphasized the importance of empowering patients and families to voice concerns when they suspect medical errors.
Health Secretary Wes Streeting praised Martha’s parents for their advocacy efforts, stating that Martha’s rule places patient safety at the forefront of healthcare. Streeting highlighted the significant impact of Martha’s rule in enhancing patient care and rebuilding trust in the NHS.
Professor Meghana Pandit, NHS national medical director, acknowledged the profound influence of Martha’s rule in facilitating better communication between hospitals, patients, and families. Pandit commended the relentless efforts of Martha’s parents and healthcare professionals in implementing this life-saving initiative successfully.
In conclusion, Martha’s rule represents a crucial reform in the healthcare system, emphasizing patient-centered care and the importance of listening to patients’ concerns to prevent avoidable tragedies. This initiative stands as a testament to Martha’s memory and the lives it continues to impact positively.