Martha's Rule

Martha's Rule

Martha’s Rule builds on NHS England’s Worry and Concern Improvement Collaborative pilot, which concluded in 2024. NHSE have tested and implemented different ways of escalating (and recording) patient, family and carer concern, in relation to deterioration. 

Phase 1

The 3 proposed components of Martha’s Rule are:

1. All staff in NHS trusts must have 24/7 access to a rapid review from a critical care outreach team, which they can contact should they have concerns about a patient.

2. All patients, their families, carers, and advocates must also have access to the same 24/7 rapid review from a critical care outreach team, which they can contact via mechanisms advertised around the hospital and more widely if they are worried about the patient’s condition. This is Martha’s Rule.

3. The NHS must implement a structured approach to obtain information relating to a patient’s condition directly from patients and their families at least daily. In the first instance, this will cover all inpatients in acute and specialist trusts.

Please see our resources and news section for links to the Yorkshire Quality and Safety Research Group's work around Martha's Rule