NHS to roll out 'Martha's Rule' from April, giving patients and families the right to an urgent second opinion

The head of the NHS has announced plans to roll out a new system across England that will give seriously ill patients and their families access to a second opinion if their condition worsens.

As part of Martha’s Rule, which will be rolled out from April, patients, families, carers, and staff will have round-the-clock access to a rapid review from a separate care team if they are worried about a person’s condition.

In addition, health staff at participating hospitals will formally record daily insights and information about a patient’s health directly from their parents or families, making sure any changes in behaviour or condition are noted by the people who know the patient best. 

The new process follows the death of 13-year-old Martha Mills in 2021, who died after developing sepsis while being treated for a pancreatic injury at King's College Hospital NHS Foundation Trust in London.

Martha suffered the injury after falling off her bike while on holiday in Wales. An inquest following her death found that there were several missed opportunities to refer her to intensive care and that she probably would have survived if doctors had identified sooner that her condition was rapidly deteriorating.

Her parents, Merope Mills and Paul Laity, campaigned for Martha's Rule following their daughter's tragic death, saying 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."

Merope Mills previously said that she and her husband had been ignored when they raised concerns about Martha's condition and asked for her to be moved to intensive care.

The also said their daughter's death was "a preventable death but Martha's Rule will mean that she didn't die completely in vain".

Martha's Rule is planned to be extended to all acute hospitals, subject to government funding, with the programme evaluated throughout this year and next. About two-thirds of hospitals - at least 100 - will initially be able to apply to participate in the scheme.

The new system has been backed by the government, with Health Secretary Victoria Atkins saying, "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."

She told BBC Breakfast the service would be rolled out across England "step by step".

"This is something I believe very strongly in, and indeed the whole of government does, and so we will be rolling this out across England and supporting hospitals to make sure that this service is as we'd all expect it to be.

"Namely it is there to help divert the horrific circumstances that we saw happen to Martha is prevented and [to ensure] no other family has to go through what Merope and Paul have had to go through."

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