Overview

You know yourself or your loved one better than anyone. If you’re worried that a health condition is getting worse, please talk to us.

Our clinical response team can help if you're concerned about the condition of a patient who is staying on one of our wards.

What is Martha's Rule?

We have introduced Martha’s Rule to help spot any unexpected signs of your or your loved one’s condition getting worse. It also encourages you to ask for a rapid review if you’re worried about this.

You might notice small changes before they show up in our routine tests. These changes could be early warning signs that someone’s condition is getting worse.

How we monitor patients

We regularly check patients’ vital signs, such as heart rate, temperature, and blood pressure. The frequency of these checks depends on the patient’s condition. Sometimes we need to wake patients to do these checks.

We'll also ask patients at least once every day if they're feeling better or worse. This is to help spot any unexpected changes in their condition.

What to do if you're worried

1. First, speak to the team that’s caring for you or your loved one.

2. If, after speaking to the care team, you are still worried and feel your concerns are not being addressed, call for a rapid review.

We check the answerphone often, so please call us and leave a message.

What we’ll do

Your call will go to a different team in our hospital, who specialise in the care of critically-ill patients. When they get your message, they will:

• visit the patient to check on their condition
• talk to medical staff and other health professionals as needed
• agree actions with the staff looking after the patient

If the patient gives us permission, we'll call you back to let you know the actions we have taken, and tell you how they are.

This service is available 24 hours a day, 7 days a week.

We will regularly ask for your views and take your concerns seriously. We see you as a partner in the care we give, and want you to raise any worries you have.

Difference between Martha’s Rule and getting a second opinion

Martha’s Rule allows hospital inpatients and their families to get a rapid review if a patient’s condition is getting worse.

A second opinion is when you want to see a different consultant to discuss any diagnosis or treatment. This is not usually within an emergency setting or an intensive care unit.

Background of Martha’s Rule

Martha Mills died in 2021 after developing sepsis in hospital. She had been admitted with an injury to her pancreas after falling off her bike. The care team did not act on her family’s concerns about Martha’s condition getting worse.

In 2023 a coroner ruled that Martha, aged 13, would probably have survived if she had been moved to intensive care earlier.

Guys’ and St Thomas’ hospitals used to call this ‘Call if concerned’, but it’s now called ‘Martha’s Rule’ and is active across every NHS site in England.