Partners: Chelsea and Westminster Hospital NHS Foundation Trust, London North West University Healthcare NHS Trust, Hillingdon Hospitals NHS Foundation Trust, Imperial College Healthcare NHS Trust
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 three proposed components of Martha’s Rule are:
1. Structured Daily Patient Check-ins: Patients will be asked, at least daily, about how they are feeling and whether they are getting better or worse. This information will be acted upon in a structured way.
2. Staff Escalation: All staff will be able, at any time, to request a review from a different team if they are concerned that a patient is deteriorating and their concerns are not being addressed.
3. Patient and Family and Carer Escalation: This escalation route will also always be available to patients themselves, their families, and carers, and will be advertised across the hospital.
In November 2024 the first phase of Martha’s Rule launched in all eight hospital pilot sites across NWL’s four Acute Trusts. ICHP played a key role in embedding a centrally coordinated implementation support model, establishing a NWL Martha’s Rule COP. This brought together key stakeholders across pilot sites, NWL ICB’s Operational Delivery Network, and NWL Critical Care Network to:
• Share resources and learning to reduce duplication of efforts
• Solve shared challenges
• Support a consistent approach to implementation and measurement
• Use quality improvement (QI) methods to design and test improvements across the pathway
Our team ran a series of ‘Moments’ sessions (a framework to explore local safety cultures through everyday practices), with 55 attendees from all four NWL Acute Trusts and NWL ICB, comprising patient safety leads, managers, specialists, cultural safety leads, QI Midwives, and Martha’s Rule Implementation Leads.
ICHP’s PSC team will continue to work with NWL’s Acute Trusts to embed implementation, including providing regular updates to NHS England to inform wider roll-out across the country.
“ICHP has been incredibly pro-active – ensuring our pilot sites are supported, share information and capitalise on good practice. The team bring a QI lens and act as a conduit between the national team
and providers, ensuring they focus on deliverables. This has been vital. The NWL 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.” – Michaela Jones, Lead Nurse and Associate Director of the NWL Critical Care Network
