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Martha’s Rule to be introduced into hospital trusts from April 2024

By Clare Gooch

Published In: Clinical Negligence

Martha Mills, a young girl, was admitted to King's College Hospital, south London, in 2021, after injuring her pancreas slipping on to the handlebars of her bike while cycling. Martha’s health continued to deteriorate and she developed sepsis, a potentially fatal infection if not treated immediately. Martha’s parents, raised their concerns to three Consultants in the hopsital, who all continued to reassure them that Martha would be fine and this was a normal infection. Martha’s parents, concerned about her deteriorating condition, repeatedly asked that Martha be moved and treated in intensive care but they were ignored. Sadly, Martha later died of sepsis.

An inquest was held into the cause of Martha’s death. Her parents expressed that with continuing doubt in their daughter’s condition they had nowhere to go and no one to speak to. They just had to trust the doctors and their opinion. After hearing evidence relating to Martha’s medical care, the Coroner found that with better care, Martha could have survived.

Following her death, Martha’s parent’s have campaigned to have new systems implemented in Hospital Trusts that allows patients to have a second opinion. Whilst patients already have the right to a second opinion if their condition deteriorates, trusts currently operate different systems, which means this isn’t always possible to seek a second opinion. More often than not, patients do not know who they can talk to, to seek a second opinion, Martha’s mother explained “Challenging doctors could be difficult”. Without the new scheme, many patients and their families would not know how.

The government has backed plans  to roll out a system giving seriously ill patients easy access to a second opinion if their condition worsens. About two-thirds of hospitals (at least 100)  will initially be able to apply to participate in the scheme.

The County Durham and Darlington NHS Trust is to be the first in the North East to adopt "Martha's Rule".

Under the new scheme, participating hospitals will receive government funding for posters and leaflets informing patients and their families that they can directly ask a team of critical-care medics for a "rapid review" of treatment, NHS England said.

The reviews will be carried out by a senior doctor or nurse from elsewhere in the building, who specialise in the care of patients who are deteriorating.

Medics will also formally record families' observations of a patient's condition or behaviour.

The British Medical Association (BMA), which represents doctors, said it welcomed the scheme, but said it would need to be carefully monitored before being fully rolled out.

Dr Vishal Sharma, who chairs the BMA consultants committee, said: "For this to result in improvements for patients, it is essential that the current workforce crisis is addressed so that critical care outreach teams have the necessary staff they need to deliver this initiative."

At Switalskis, we represent many patients and families who would have sought a second opinion in the care they have received. Some have sadly lost their lives or a loved one as a result of poor medical care and many of these may have had a different outcome if they had received a second opinion. We welcome the introduction of Martha’s Rule and hope that this will help patient’s and families have a voice when it comes to their own care or care of a loved one, particularly where they are concerned about a declining health condition.

If you or a loved one has been impacted by a delay in treatment, please reach out and make contact with us so that we can begin to support you. Call 0800 138 0458 or email .

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Clare has worked in Medical Negligence for over 10 years.  She’s a Senior Associate Solicitor in our Medical Negligence team based in Switalskis’ London office.

Senior Associate Solicitor

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