NHS extends Martha's Rule to all A&E departments in England by 2028
NHS England is extending Martha's Rule, which lets patients, families and staff seek an urgent second review when they fear a patient is deteriorating, to all A&E departments by 2028.
The Full Story
A plain summary built from the channels that reported this story.
England's patient safety scheme Martha's Rule is being extended to all A&E departments by March 2028, following a pledge from NHS England. The scheme allows patients, their relatives and NHS staff to ask for a review from a different medical team if they are worried that a patient is deteriorating and their concerns are not being responded to. It offers 24-hour access to an urgent review.
It is named after Martha Mills, who was 13 when she was admitted to King's College Hospital in London in 2021 with serious pancreatic injuries after falling off her bike. She developed an infection and then sepsis. Her parents, Merope and Paul, raised concerns that her condition was worsening, but the family felt their concerns were ignored. A coroner ruled that Martha would probably have survived if she had been moved to intensive care earlier. She died from sepsis.
The scheme was introduced by NHS England in 2024 for patients already in hospital. Between September 2024 and July this year, more than 19,000 calls were made. NHS England says it is already making a difference. Recently, it was announced that Martha's Rule would be introduced in maternity and neonatal care. The latest pledge is to roll it out to all A&E departments in England by March 2028.
Merope Mills said she felt completely powerless in hospital and had nowhere to turn when she did not think anyone was listening. She said the introduction of Martha's Rule means people like her family will be able to make that request if they feel deterioration is happening and nobody is being listened to. She also said she was pleased and absolutely delighted that more people around the country will have access to it as and when they need it.
Jason Watkins, the actor, lost his daughter Maud to sepsis. He said that when you lose a child you are left with a conundrum, and that while everyone did everything they could, perhaps a system of care could be improved so sepsis may have been detected earlier. He said that is what Martha's Rule can do.
Dr Amos, a GP, said the rule changes the culture of how clinicians and patients interact. She said just knowing it can be involved can get clinicians to think twice, and worried family members can feel more empowered to raise questions. She said it is not about damaging the relationship but enhancing it and allowing a two-way conversation.
The Royal College of Emergency Medicine welcomed the further rollout. It said the scheme could potentially save lives but should be evaluated to ensure it is working as intended. There are also concerns about pressure on already overstretched A&E staff. Trials found that Martha's Rule worked pretty well, allowing medics to pause and see the whole picture, according to coverage of the scheme. The advice to families is to mention Martha's Rule, raise concerns with a member of staff, or look at the trust website.
Scotland is running trials with Martha's Rule. Northern Ireland does not yet have it. Wales has its own version.
On screen
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Key Claims
Claims reported during this story's coverage, mapped by channel. Ordered by how many channels carried each claim.
| Claim | Channel 5 | BBC One | Channel 4 |
|---|---|---|---|
| Martha's Rule allows patients, relatives and NHS staff to request a review or second opinion, with 24-hour urgent review if concerns about a patient's care are not being addressed. | |||
| The NHS is rolling out the Martha's Rule patient safety programme to A&E departments in England. | |||
| A coroner ruled that Martha Mills would probably have survived if she had been moved to intensive care earlier. | · | · | |
| Martha's Rule was introduced in 2024 for patients already in hospital and generated more than 19,000 calls between September 2024 and July this year. | · | · |
Channel Perspectives
What each channel focused on, with key quotes.
Channel 4 covered Martha's Rule briefly in a wider news summary dominated by economic and political items. It framed the rollout as already happening across every A&E department in England and stressed the family's ignored concerns and the coroner's finding. It did not include the 2028 deadline, call figures or staff concerns.
- “A system known as Martha's Rule is now being rolled out across every A&E department in England, allowing patients, their relatives and NHS staff to ask for a review of their care.”
- “Her family's concerns about her treatment had been ignored and the coroner ruled that she would probably have survived if she'd been moved to intensive care earlier.”
5 covered the story in both its lunchtime and evening bulletins. The lunchtime report was a brief update that stressed 24-hour access to an urgent review, while the evening segment was more detailed, with a correspondent walking through the family's experience, possible pressure on overstretched A&E staff, and a GP's view. It gave the rollout date as 2028 and advised viewers to mention Martha's Rule if worried.
- “The NHS is extending a patient safety programme to accident emergency departments in England, allowing people to get a second opinion on the treatment of a loved one.”
- “I felt completely powerless when we were in hospital. I had nowhere to turn when I didn't think anyone was listening to me.”
- “What it does is it changes the culture of how clinicians and patients interact.”
BBC ONE West gave the most detailed package, led by its health editor. It reported the rollout timeline to March 2028, call figures, the expansion into maternity and neonatal care, and reaction from the Royal College of Emergency Medicine. It also noted the positions in Scotland, Northern Ireland and Wales, and included the actor Jason Watkins on sepsis detection.
- “A specialist helpline that triggers an urgent review of a patient's care is to be rolled out across all emergency departments in England.”
- “Between September 2024 and July this year, more than 19,000 calls were made.”
- “The Royal College of Emergency Medicine welcomed the further rollout of the scheme and said it could potentially save lives, but it should be evaluated to ensure it was working as intended.”
Broadcast Timeline
News broadcasts tracked for this story, in time order.