Source: NHS England published on this website Tuesday 22 September 2026 by Jill Powell
Martha’s Rule is a patient safety initiative to support the early detection of deterioration by ensuring the concerns of patients, families, carers and staff are listened to and acted upon.
It has been developed in response to the death of Martha Mills and other cases related to the management of deterioration. Central to Martha’s Rule is the right for patients, families and carers to request a rapid review if they are worried that a patient’s condition is getting worse and their concerns are not being responded to.
NHS trusts are working hard to put Martha’s Rule in place in all acute inpatient settings. While it is not available everywhere yet, implementation in adult and paediatric inpatient settings is expected to be complete during 2026/27. More details are available in the Implementing Martha’s Rule section below.
If you or a person you care for are admitted to hospital, you can check whether Martha’s Rule is available by:
- visiting the trust’s website
- asking staff on the ward
Martha’s story
Martha Mills died in 2021 after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling off her bike. Martha’s family’s concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that Martha, aged 13, would probably have survived had she been moved to intensive care earlier.
In response to this and other cases related to the management of clinical deterioration, the then Secretary of State for Health and Social Care and NHS England committed to implement ‘Martha’s Rule’ across the NHS.
