The Walton Centre joins rollout of national ‘Martha’s Rule’ major patient safety initiative

The Walton Centre has joined a national initiative which aims to support patients and families who want to seek urgent reviews if their loved one’s condition deteriorates.

Last year, the specialist Trust implemented ‘Call 4 Concern’, which is one of the ways in which The Walton Centre will implement Martha’s Rule.

The NHS announced that 143 hospital sites will test and roll out Martha’s Rule in the first year, as part of a major patient safety initiative, following the announcement in February of NHS England funding.

The initial target was to enrol at least 100 sites, but due to significant interest from frontline clinicians this has been expanded, meaning this first phase of the programme will be in place at 143 locations across the country by March 2025.

Evaluation of how the system works in these sites over the course of this year will inform proposals for Martha’s Rule to be expanded further across all acute hospitals, subject to future government funding.

The purpose of Martha’s Rule is to provide a consistent and understandable way for patients and families to seek an urgent review if their or their loved one’s condition deteriorates and they are concerned this is not being responded to.

The scheme is named after thirteen-year-old Martha Mills, who died from sepsis having been treated at King’s College Hospital, London, in 2021, due to a failure to escalate her to intensive care, and after her family’s concerns about her deteriorating condition were not responded to.

NHS England is working with Martha’s parents to develop materials to advertise and explain the initiative in hospitals across the country, to ensure it is something that all patients, staff, and their families can recognise.

Martha’s Rule is to be made up of three components to ensure concerns about deterioration can be swiftly responded to.

Firstly, an escalation process will be available 24/7 at all the 143 sites, advertised throughout the hospitals on posters and leaflets, enabling patients and families to contact a critical care outreach team that can swiftly assess a case and escalate care if necessary. Secondly, NHS staff will also have access to this same process if they have concerns about a patient’s condition.

Finally, alongside this, clinicians at participating hospitals will also formally record daily insights and information about a patient’s health directly from their families, ensuring any concerning changes in behaviour or condition noticed by the people who know the patient best are considered by staff.

Extensive campaigning by her parents Merope and Paul, supported by the cross-party think tank Demos, saw widespread support for a single system that allows patients or their families to trigger an urgent clinical review from a different team in the hospital if the patient’s condition is rapidly worsening and they feel they are not getting the care they need.

Merope Mills and Paul Laity, Martha’s parents, said: "We are pleased that the roll-out of Martha's Rule is off to a flying start and that the need for it has been so widely recognised. It will save lives and encourage better, more open, communication on hospital wards, so that patients feel they are listened to, and partners in their healthcare." 

Nicola Martin, The Walton Centre’s Chief Nurse, said: “We’re proud to join the other NHS hospitals taking part in this initial rollout of Martha’s Rule. Here at The Walton Centre, our clinical staff have always worked closely with families and friends of patients receiving care and treatment through Call 4 Concern. Supporting this process through Martha’s Rule will mean every patient will get an enhanced level of support and care at what can be a crucial part of their lives.”

Professor Sir Stephen Powis, NHS national medical director, said: “Rolling out Martha’s Rule to over 143 NHS sites in this first phase will represent one of the most important changes to patient care in recent years, and we are pleased to have seen such interest from hospitals right across the country, all thanks to the moving and dedicated campaigning by Martha’ parents, Merope and Paul. 

“That is why today is such an important milestone, with the NHS outlining the 143 sites where this major patient safety initiative will be rolled out later this year, allowing staff, patients and families to immediately raise concerns and bring about an escalation in care in an easily recognisable and fast way.

“The inclusion of daily insights from families about their loved ones’ condition within patient records is also a really significant step and will help staff identify changes and deterioration using insights from those who know the patient best. While thankfully the need for escalation of care will hopefully only be needed in a limited number of cases, this three-step safety net has the opportunity to truly transform patient care and safety.”

NHS national patient safety director and senior responsible officer for Martha’s Rule, Dr Aidan Fowler, said: “Working closely with Martha’s parents and colleagues across the NHS over the last few months on this rollout, I am in no doubt this programme will deliver clear change and it has been so encouraging to see how many hospitals have shown interest in being part of delivering these all-important patient safety measures this year.

“With new processes that enable both patients and staff to raise concerns if they see someone’s condition worsening, and the inclusion of patients and their loved ones’ insights in medical records, these measures can help us better identify and manage deterioration as part of wider work, which is a key priority for us and will no doubt lead to improvements in the care patients receive.”

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Notes to editors

Further information, or to arrange an interview, please contact the Communications Team at The Walton Centre on 0151 556 3397 or wcft.communications@nhs.net

The Walton Centre NHS Foundation Trust is the only hospital trust in the UK specialising in neurology, neurosurgery and pain services. Although the majority of patients come from Merseyside, Cheshire, North Wales, Lancashire and the Isle of Man, for some specialist treatments of complex disorders we see patients from all parts of the country, referred by their GPs or other neurologists, neurosurgeons and pain clinicians.

The Walton Centre NHS Foundation Trust was rated as ‘Outstanding’ by the Care Quality Commission. The independent regulator of all health and social care services in England published its rating on Friday 21 October 2016, following announced and unannounced inspection visits to the Trust in April 2016.

For more information please visit: www.thewaltoncentre.nhs.uk or follow the Trust on Twitter, Facebook or Instagram.

The Walton Centre NHS Foundation Trust, Lower Lane, Fazakerley, Liverpool L9 7LJ
0151 525 3611