Martha's rule to be expanded to every A&E in England

NHS England is expanding Martha's Rule to every hospital accident and emergency department and waiting room in England, with a full rollout scheduled for completion by March 2028. The initiative, which allows patients and families to request an urgent second opinion via a dedicated helpline, was created following the 2021 death of 13-year-old Martha Mills from untreated sepsis. A pilot trial across seven trusts resulted in 69 calls, leading to life-saving interventions like urgent surgeries.

Martha's rule A&E expansion

• ▪The expansion of Martha's Rule to accident and emergency departments, including waiting rooms, will be completed via a phased rollout by March 2028.
• ▪The expansion of Martha's Rule to accident and emergency departments follows its previous introduction on hospital inpatient wards in 2024 and its expansion to maternity and neonatal units in June 2026.
• ▪NHS England announced that Martha's Rule, which allows patients, families, and staff to request an urgent second opinion, is being expanded to every hospital accident and emergency department in England.

Martha Mills case background

• ▪A coroner ruled that Martha Mills would have survived her 2021 illness if medical staff had transferred her to the intensive care unit earlier.
• ▪Martha's Rule was established following the 2021 death of 13-year-old Martha Mills, who died from sepsis at King's College Hospital NHS Foundation Trust in London after medical staff failed to escalate her care.
• ▪Merope Mills and Paul Laity, the parents of Martha Mills, campaigned for years to introduce the rule after stating that their concerns about their daughter's deteriorating condition were repeatedly dismissed by medics.

Lives saved through reviews

• ▪NHS England reported that during the first 16 months of Martha's Rule following its 2024 introduction, hospital helplines received over 10,000 calls, potentially saving 446 lives.
• ▪NHS England data shows that the highest-ever monthly total of calls made via Martha's Rule occurred in July 2026, with 1,678 calls recorded.

Patient safety improvement mechanism

• ▪A 2025 study by Imperial College London on global patient safety ranked the United Kingdom 21st out of 38 OECD countries based on 2021 data, highlighting issues with deaths from treatable causes like sepsis.
• ▪Under Martha's Rule, patients, families, and staff can call a dedicated hospital helpline to trigger an urgent review by an independent medical team if they believe a patient's deteriorating condition is being ignored.