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Martha’s Rule at St George’s Hospital

At St George’s Hospital, patient safety is at the heart of everything we do. As part of our continued commitment to delivering the highest standards of care, we are proud to support Martha’s Rule – a national patient safety initiative designed to strengthen the recognition and response to clinical deterioration in hospital.

Martha’s Rule gives patients and their families the right to request an urgent clinical review if they are concerned that a patient’s condition is worsening. St George’s is one of the NHS trusts implementing this important service as part of the national rollout across hospitals in England.

 

 

What does this mean in practice?

If you are an inpatient, or a relative or close friend of someone receiving inpatient care, you can request an urgent review at any time if you are worried about a deterioration in the patient’s condition.

When contacting the service, you will be asked to provide:

  • The patient’s full name
  • The name of the ward
  • A brief description of your concerns
  • Your relationship to the patient and your contact details

Every request is carefully reviewed and assessed. Where appropriate, a specialist doctor or nurse from our Critical Care Outreach Team (CCOT) will attend the ward promptly to assess the patient and ensure they are receiving the appropriate treatment and support.

Availability of the service

Martha’s Rule at St George’s Hospital is available 24 hours a day, seven days a week, providing reassurance and access to urgent review whenever it is needed.

Who are the Critical Care Outreach Team (CCOT)?

The Critical Care Outreach Team consists of highly skilled specialist doctors and nurses with expertise in caring for patients who are:

  • Critically unwell
  • Showing signs of deterioration
  • Recovering from critical illness

The team works around the clock to support ward staff and ensure that patients receive timely, expert intervention when required.

When should you make a call?

We strongly encourage you to raise your concerns initially with the ward nurse or doctor, as they are directly involved in the patient’s care. However, if you remain worried after speaking with the clinical team, you may contact the Critical Care Outreach Team directly through Martha’s Rule.

Patients, families and friends should request a review if:

  • There is a noticeable change in the patient’s condition
  • Symptoms appear to be worsening
  • You feel that something is not right

Your voice matters. If you are concerned, we want to hear from you.

When to make a call if you are concerned

Inpatients and their families and friends should call 0735 037 0582  if there is a noticeable change in the inpatient’s health.

We encourage you to first speak with the ward nurse or doctor. If, following this, you have ongoing concerns, you can contact the CCOT.

Martha’s Rule and second opinions – what’s the difference?

Martha’s Rule is specifically designed for urgent situations, where a patient’s condition appears to be deteriorating and immediate clinical review is required.

A second opinion involves asking another consultant to review a diagnosis or treatment plan. This process is not intended for urgent or emergency concerns.

If the concern is not clinically urgent, you are encouraged to speak to the nurse in charge of the area and/or directed to our Patient Advice and Liaison service (PALS) who will be able to help you.

The story behind Martha’s Rule

Martha’s Rule was introduced following the death of Martha Mills in 2021. Martha developed sepsis while in hospital receiving treatment for a pancreatic injury. During her admission, concerns raised by her family about her deteriorating condition were not escalated.

In 2023, a coroner concluded that Martha would likely have survived had she been transferred to intensive care earlier.

After determined campaigning by Martha’s parents, and amid wider national concerns about recognising and responding to patient deterioration, the Department of Health and Social Care and NHS England introduced Martha’s Rule.

This initiative ensures that patients and those who know them best are listened to – and that concerns about clinical deterioration are taken seriously and acted upon promptly.

Our commitment

At St George’s Hospital, London, we are committed to fostering a culture of openness, partnership and safety. Martha’s Rule strengthens our ability to respond quickly, listen carefully and act decisively – because every patient deserves to feel heard, respected and protected.