Martha's Rule to be extended to A&E departments in England

Martha's Rule will be extended to hospital A&E departments in England, making it easier for staff and families to ask for a second opinion.

The rule, brought in after the death of 13-year-old Martha Mills, gives formalised, round-the-clock access to an urgent review and is advertised throughout hospitals.

Martha developed sepsis while under the care of King's College Hospital NHS Foundation Trust in south London in 2021, with a coroner ruling she would not have died if she had been put in intensive care earlier.

Her parents, Merope Mills and Paul Laity, who had voiced concerns about her worsening condition, were repeatedly dismissed.

Under the new plan, the NHS will extend Martha's Rule, which is already being implemented on all inpatient wards.

It means patients, loved ones, and busy A&E staff can call a number to trigger an urgent review if a patient's condition is deteriorating and they believe their concerns are not being listened to.

The phased rollout will be completed by March 2028.

A pilot in seven trusts has already tested whether the rule could be used safely in A&E.

During an eight-month pilot, 69 calls were made to dedicated phone numbers, with some patients going on to have urgent surgery or being transferred to intensive care, NHS England said.

Professor Aidan Fowler, national director of patient safety at NHS England, said the ability to raise concerns about deterioration rapidly and trigger a rapid review of care is "essential" and Martha's Rule is already having a "transformative effect in making our acute care even safer".

He pointed out early testing has shown thousands of calls made by patients, families and staff members have in many cases led to changes in treatment and "potentially life-saving interventions".

Health minister Baroness Merron said: "Martha's Rule is about making sure patients and their loved ones are heard when they raise concerns about their care.

"Expanding it to A&E will give patients, families and staff another way to speak up when they are worried that someone's condition is getting worse, ensuring concerns are acted on quickly."

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Hospitals are also expected to extend Martha's Rule to A&E, maternity and neonatal units by March 2028.

Latest figures for July 2026 show the highest-ever monthly total of calls made via Martha's Rule was 1,678.

A report in January found the UK could be lagging behind countries such as Norway, Switzerland, Japan, Spain and Italy when it comes to patient safety.

A chart of the safest places to receive care from 38 countries in the Organisation for Economic Co-operation and Development (OECD) ranked the UK in 21st place, based on 2021 data.

The global state of patient safety 2025 study, from Imperial College London, included key aspects of patient safety, one of which was deaths from treatable causes, such as sepsis and blood clots.

(c) Sky News 2026: Martha's Rule to be extended to A&E departments in England