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Government to introduce ‘Martha’s rule’ on patient safety in English hospitals

Martha Mills died after doctors failed to admit her to intensive care (Mills/Laity family photograph/PA) (PA Media)
Martha Mills died after doctors failed to admit her to intensive care (Mills/Laity family photograph/PA) (PA Media)

The Government has committed to introducing Martha’s rule in England’s hospitals to give patients the right to a second opinion if they believe their concerns are being dismissed by NHS staff.

Merope Mills, whose daughter Martha, 13, died after doctors failed to admit her to intensive care, met Health Secretary Steve Barclay on Wednesday.

The rule will give patients, families and carers the chance to easily request a second opinion from senior medics in the same hospital, in the event of a suspected deterioration or serious concern.

Ms Mills said: “I met with the Secretary of State for Health yesterday and welcome the news that he will introduce Martha’s rule across NHS England hospitals.

A team has been appointed to work out implementation; we appreciate Stephen Barclay’s commitment to work at speed in order to make Martha’s rule happen as soon as possible

Merope Mills

“He is prioritising its introduction and is ready to allocate funds to the initiative.

“It will be one standardised and recognisable right that will become part of patients’ experience on hospital wards.

“A team has been appointed to work out implementation; we appreciate Stephen Barclay’s commitment to work at speed in order to make Martha’s rule happen as soon as possible.

“Our incredible daughter Martha lost her life needlessly, far too young. We hope this new rule will put some power back into the hands of patients and prevent unnecessary deaths.”

Martha died in 2021 after developing sepsis while under the care of King’s College Hospital NHS Foundation Trust in south London.

A coroner ruled last year she would most likely have survived if doctors had identified the warning signs and transferred her to intensive care earlier.

Martha was being looked after at King’s after suffering a pancreatic injury in a fall from her bike while on a family holiday in Wales. King’s is a specialist national referral centre for children with pancreatic problems.

I had been 'managed', I hadn't been listened to and I felt powerless

Merope Mills

An inquest heard there were several opportunities to refer Martha to intensive care but this did not happen. The trust has since apologised for mistakes in Martha’s care.

Martha’s mother, who is an editor at the Guardian, has said she and her husband, Paul Laity, raised concerns about Martha’s deteriorating health a number of times but these were not acted upon.

At one point Martha began to bleed heavily through a tube inserted into her upper arm and through a drainage tube.

She also developed a rash, with her mother voicing her concerns to staff that Martha would go into septic shock over a bank holiday weekend.

One of the trust’s own intensive care doctors told the inquest into Martha’s death he would “100%” have admitted her if he had seen her.

The Health Secretary told Radio 4’s Today programme that the case set out by Ms Mills is “compelling” and he will “move quickly” to implement Martha’s rule, particularly in paediatrics.

“It is, I think for everyone that has heard it, an absolutely heartbreaking case and I’m determined that we ensure we learn the lessons from it,” Mr Barclay said.

He has tasked patient safety commissioner Henrietta Hughes to work with NHS England to look at proposals and build on evidence from trusts where there are similar standards in place already.

When asked if there will be “one rule across the NHS” to make things easier for patients, he answered: “There may be different circumstances, for example around mental health settings. We should be looking at this in the context of primary care.”

He added: “I think the more standardisation we can have, the easier it is then to communicate to patients.”

Ms Mills told the PA news agency earlier this month: “At King’s College Hospital there were no consultants present after the ward round during the weekend when Martha deteriorated, and so when I had doubts about Martha’s care I had no-one senior to turn to.

“I mentioned my concerns to a junior doctor when he misdiagnosed her rash, but he ignored me; questioning him further would have involved a confrontation.

“I talked to a nurse, but she said to trust the doctors. I didn’t have the language or knowledge to request a critical care review.

“I had been ‘managed’, I hadn’t been listened to and I felt powerless.”

A spokeswoman at King’s has said the trust remains “deeply sorry that we failed Martha when she needed us most”.

She said a number of improvements are in place to help identify deteriorating children early, including mandatory sepsis training for all clinical staff in paediatrics.