Martha's Rule Extended to All UK Emergency Rooms, Offering Second Opinions

The United Kingdom's National Health Service (NHS) has expanded Martha's Rule to include all emergency rooms, enabling patients to request a second opinion if they are unhappy with their care. Previously limited to hospital wards for inpatients, the rule now extends to individuals in A&E departments and those awaiting initial treatment.

The initiative, described as 'life-saving,' was first implemented in 2024 following the death of 13-year-old Martha Mills. Mills died in hospital in 2021 after developing sepsis, and a coroner later determined she would have survived had her care been escalated to intensive care sooner. Her parents reported that their concerns about her deteriorating condition were repeatedly dismissed.

Under the new procedure, patients, their families, and healthcare staff can utilize a dedicated phone number to trigger an urgent review if a patient's condition worsens and concerns are not being addressed. The rollout across all NHS hospitals is scheduled for completion by March 2028.

An eight-month pilot program involving seven NHS trusts tested the application of Martha's Rule in A&E settings. During this trial, 69 calls were made, leading to some patients receiving urgent surgery or transfer to intensive care, according to NHS England. Professor Aidan Fowler, national director of patient safety at NHS England, stated that Martha's Rule will serve as a "critical new lifeline" to enhance care and save lives in UK emergency departments.

This expansion follows the rule's introduction in maternity services last summer, prompted by reviews that highlighted significant and persistent failures in care. Donna Ockenden’s comprehensive review of maternity and neonatal services found instances where mothers and babies were ignored, complaints dismissed, and opportunities to identify deteriorating patients were missed, alongside a culture of silencing staff and parents.

In maternity units, Martha's Rule allows parents to request a rapid review from an independent medical team if a baby or mother's condition deteriorates and concerns are not being adequately addressed. In July 2026, Martha's Rule saw a record 1,678 calls made.

Recent analyses have placed the UK lower than other developed nations in patient safety rankings. A 2025 study from Imperial College London, based on 2021 data, ranked the UK 21st out of 38 OECD countries for patient safety, considering factors such as deaths from treatable conditions like sepsis and blood clots. The expansion of Martha's Rule aims to address these concerns within emergency care settings.