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‘Life-Saving’ Martha’s Rule To Expand To Emergency Departments Across England: What It Means

‘Life-Saving’ Martha’s Rule to Expand to Emergency Departments Across England: What It Means

<span>NHS England</span> has announced the expansion of Martha’s Rule to all hospital emergency departments and waiting rooms in England to help patients, families and staff raise concerns about worsening conditions.

Martha’s Rule was introduced following the death of 13-year-old <span>Martha Mills</span> and mandated at acute inpatient sites in 2025. Its expansion to A&amp;Es will be phased in and completed by March 2028.

“A&amp;Es see some of our most vulnerable patients, so the ability to raise concerns about deterioration quickly and trigger a rapid review of care is essential,” said Professor Aidan Fowler, National Director of Patient Safety at NHS England.

“Martha’s Rule is already having a transformative effect in making our acute care even safer, and by expanding Martha’s Rule into A&amp;Es, we are giving even more patients, their families and NHS staff a critical new lifeline to help improve care and save more lives,” he added.

<h2>How Will Martha’s Rule Work In A&amp;E?</h2>

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An NHS England pilot, conducted between September 2025 and March 2026, found that Martha’s Rule could work alongside existing emergency-care procedures to identify early signs of deterioration without requiring additional clinical staff.

During the pilot, 69 calls were made to dedicated Martha’s Rule numbers. Some resulted in urgent surgery or transfer to intensive care.

“Martha’s Rule is about making sure patients and their loved ones are heard when they raise concerns about their care,” said Health and Social Care Minister Baroness Merron.

“Expanding it to A&amp;E will give patients, families and staff another way to speak up when they are worried that someone’s condition is getting worse, ensuring concerns are acted on quickly,” Merron added.

Martha’s Rule is named after 13-year-old Martha Mills, who developed sepsis while being treated at King’s College Hospital NHS Foundation Trust in south London in 2021 and later died.

Her parents repeatedly raised concerns about her worsening condition. An investigation later found that Martha might have survived if signs of deterioration had been recognized and she had been transferred to intensive care.

Her parents subsequently campaigned for a formal system allowing patients and families to raise concerns and seek an urgent clinical review.

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<ul><li>Patients are asked daily how they are feeling, with responses recorded.</li><li>Staff can request an urgent review from another team if they are concerned about a patient.</li><li>Patients, families and caregivers can also request an urgent review if they are worried about a worsening condition.</li></ul>

Hospitals provide a dedicated number that patients and families can use to request a rapid review by a different team when concerns are not being addressed.

<h2>Has Martha’s Rule Saved Lives?</h2>

In July 2026, 1,678 calls were made through Martha’s Rule — the highest monthly total so far.

More than 19,000 calls (19,177) were made by patients, families and NHS staff between September 2024 and July 2026.

The rule has been rolled out at 221 acute adult and pediatric inpatient sites, with the current rollout expected to be completed in 2026/27.

It is also being extended to A&amp;E, maternity and neonatal units, with the wider rollout due to be completed by March 2028.

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NHS England has announced the expansion of Martha’s Rule to all hospital emergency departments and waiting rooms in England to help patients, families and staff raise concerns about worsening conditions.Martha’s Rule was introduced following the death of 13-year-old Martha Mills and mandated at acute inpatient sites in 2025. Its expansion to A&Es will be phased in and completed by March 2028.“A&Es see some of our most vulnerable patients, so the ability to raise concerns about deterioration quickly and trigger a rapid review of care is essential,” said Professor Aidan Fowler, National Director of Patient Safety at NHS England.“Martha’s Rule is already having a transformative effect in making our acute care even safer, and by expanding Martha’s Rule into A&Es, we are giving even more patients, their families and NHS staff a critical new lifeline to help improve care and save more lives,” he added.How Will Martha’s Rule Work In A&E?Also read: UK Flu Jabs Begin For Children And Pregnant Women: What You Need To KnowAn NHS England pilot, conducted between September 2025 and March 2026, found that Martha’s Rule could work alongside existing emergency-care procedures to identify early signs of deterioration without requiring additional clinical staff.During the pilot, 69 calls were made to dedicated Martha’s Rule numbers. Some resulted in urgent surgery or transfer to intensive care.“Martha’s Rule is about making sure patients and their loved ones are heard when they raise concerns about their care,” said Health and Social Care Minister Baroness Merron.“Expanding it to A&E will give patients, families and staff another way to speak up when they are worried that someone’s condition is getting worse, ensuring concerns are acted on quickly,” Merron added.Who Was Martha Mills?Martha’s Rule is named after 13-year-old Martha Mills, who developed sepsis while being treated at King’s College Hospital NHS Foundation Trust in south London in 2021 and later died.Her parents repeatedly raised concerns about her worsening condition. An investigation later found that Martha might have survived if signs of deterioration had been recognized and she had been transferred to intensive care.Her parents subsequently campaigned for a formal system allowing patients and families to raise concerns and seek an urgent clinical review.How Does Martha’s Rule Work?   The rule has three main components:Patients are asked daily how they are feeling, with responses recorded.Staff can request an urgent review from another team if they are concerned about a patient.Patients, families and caregivers can also request an urgent review if they are worried about a worsening condition.Hospitals provide a dedicated number that patients and families can use to request a rapid review by a different team when concerns are not being addressed.Has Martha’s Rule Saved Lives?In July 2026, 1,678 calls were made through Martha’s Rule — the highest monthly total so far.More than 19,000 calls (19,177) were made by patients, families and NHS staff between September 2024 and July 2026.The rule has been rolled out at 221 acute adult and pediatric inpatient sites, with the current rollout expected to be completed in 2026/27.It is also being extended to A&E, maternity and neonatal units, with the wider rollout due to be completed by March 2028.

‘life-saving’ martha’s rule to expand to emergency departments across england: what it means

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