Martha’s Rule, named after Martha Mills who tragically died in 2021, gives patients and their loved ones the right to request an urgent second opinion when they fear that a patient’s health is deteriorating, and their concerns are not being addressed by their current medical team.

Martha’s Rule was rolled out across some NHS hospitals in England from April last year, creating a clear pathway for patients and families to escalate their concerns.

The story of Martha Mills

Martha Mills tragically passed away in 2021 after suffering complications from a fall that injured her pancreas. Following her accident, she was admitted to King’s College Hospital in London under the care of the paediatric liver team. Her parents repeatedly raised concerns about her worsening condition and explicitly raised concerns that Martha had sepsis and could develop septic shock. They were not listened to.

Martha’s condition deteriorated, she developed an infection and ultimately died on 31 August 2021, at the age of 13. Her death certificate listed sepsis and refractory shock as causes of her death. The coroner concluded that Martha would likely have survived if she had been transferred to the paediatric intensive care unit.

Since then, Martha’s parents have campaigned for systemic change in how families seek second opinions in emergency situations.

Martha’s Rule

In April 2024, Martha’s Rule was put into place in 143 NHS hospitals in England, creating a clear pathway for patients and families to escalate their concerns.

The early data highlights the transformative effect Martha’s Rule is already having. 573 calls have been made across the hospitals implementing Martha’s Rule, and about 50% (286 cases) have resulted in urgent reviews by critical care staff. Of those reviews, 20% (57 cases) have led to escalated care, such as administering life-saving antibiotics or other critical interventions.

These numbers demonstrate how the policy is saving lives and act as a reminder of the importance of listening to patients and their families.

Good doctors should value input from patients and their families and be open to seeking a second opinion from colleagues. Busy doctors cannot always spot the same changes in a patient that a family who is spending every hour with the patient can. Families and loved ones can be a helpful resource to doctors and nurses.

As medical negligence solicitors, we are sadly all too familiar with the themes highlighted in Martha’s case; patients and families feeling that they are not being listened to and the consequences of the missed opportunities.