NHS England has announced the expansion of Martha’s Rule to all hospital A&E departments and waiting rooms. This initiative aims to enhance patient safety, particularly for vulnerable individuals, by enabling patients, their families, and staff to request an urgent review if a patient's condition worsens and they feel their concerns are not being addressed.
Previously, Martha's Rule was used for patients already admitted to hospital. This expansion introduces additional safeguards for those experiencing acute deterioration while in A&E departments. The nationwide rollout began following a pilot in seven trusts, which tested the escalation process in busy A&E settings between September 2025 and March 2026. The pilot indicated that the rule could function effectively alongside existing clinical procedures without requiring extra staff.
The phased implementation of Martha's Rule to A&E, maternity, and neonatal units is anticipated to be completed by March 2028. The initiative is named after Martha Mills, who died in 2021 at age 13 due to sepsis, after her family's concerns about her deteriorating condition were not acted upon.