In a major milestone for patient safety, the first phase of Martha’s Rule has now launched in all eight hospital pilot sites across four trusts in North West London: Chelsea and Westminster Hospital NHS Foundation Trust, London North West University Healthcare NHS Trust, The Hillingdon Hospitals NHS Foundation Trust and Imperial College Healthcare NHS Trust.
Imperial College Health Partners, as the host of the NW London Patient Safety Collaborative (PSC), has played a key role in embedding a centrally coordinated implementation support model which brings together key stakeholders across pilots sites, NW London Integrated Care Board’s Operational Delivery Network (ODN) and NW London Critical Care Network to:
- share resources & learning to reduce duplication of efforts
- solve shared challenges
- support a consistent approach to implementation and measurement
- use quality improvement methods to design and test improvements across the pathway.
ICHP’s PSC team will continue to work with the acute trusts in NW London to support implementation, including providing regular updates to NHS England to inform wider roll-out across the country.
Shakti Dookeran, Innovation Lead for the Patient Safety Collaborative team at ICHP, said:
“This consistent, national approach to empowering patients, family, carers and staff plays a key role to reduce physical deterioration related harm by improving prevention, identification, escalation and response. We’re pleased to be supporting the testing phase of Martha’s Rule in NW London and look forward to continuing our implementation support offer and collaboration through our community of practice.”
Michaela Jones, Lead Nurse and Associate Director of the NW London Critical Care Network, said:
“ICHP have been incredibly pro-active – joining both the Network CCO Forum Group and the Deteriorating Patient APC Quality Work Stream Steering Group, ensuring our pilot sites are supported, share information and capitalise on good practice. The team bring a Quality Improvement lens and act as a conduit between the National team and providers ensuring, they focus on deliverables. This has been vital because initially key information did not reach the right staff. The NW London PSC continues to coordinate and support collaborative working across our pilot sites with each provider at different stages on their Martha’s Rule implementation journey this has at times been challenging.”
Martha’s Rule
Martha Mills was a 13-year-old girl who died from Sepsis when she was admitted to an NHS organisation to receive treatment for pancreatic surgery. The coroner that reviewed her care ruled that Martha would probably have survived had she been moved to intensive care earlier. Her mother reflected that ‘she was not listened to, she felt managed and powerless’ in her attempt to raise concerns about Martha’s health.
In response to this and other cases related to the management of deterioration, the Secretary of State for Health and Social Care and NHS England committed to implement ‘Martha’s Rule’ to ensure the vitally important concerns of the patient and those who know the patient best are listened to and acted upon.
The first phases of the introduction of Martha’s Rule will be implemented in 143 NHS hospital sites from April 2024 which includes the offer of specialist implementation support and expertise from the Health Innovation Network’s Patient Safety Collaborative (PSC).
Martha’s Rule pilot will build on the evaluation of NHS England’s Worry and Concern Improvement Collaborative which involves seven regional pilots and began in 2023. They have been testing and implementing methods for patients, families and carers to escalate their concerns about deterioration and to input their views about their illness into the health record.
The three proposed components of Martha’s Rule are:
- All staff in NHS trusts must have 24/7 access to a rapid review from a critical care outreach team, who they can contact should they have concerns about a patient.
- All patients, their families, carers and advocates must also have access to the same 24/7 rapid review from a critical care outreach team, which they can contact via mechanisms advertised around the hospital, and more widely if they are worried about the patient’s condition.
- The NHS must implement a structured approach to obtain information relating to a patient’s condition directly from patients and their families at least daily. In the first instance, this will cover all inpatients in acute and specialist trusts.
Find out more about Martha’s Rule.
Work with us
If you’re interested in finding out more about our work on Martha’s Rule, or the work of the Patient Safety Collaborative more widely, please get in touch.
