Technology and Science · updated 1h ago · 3 min read
NHS England Rolls Out Martha’s Rule To Every A&E Department In England By March 2028
Martha’s Rule expanded to all NHS A&Es and waiting rooms by March 2028. Patients, families and staff can trigger an urgent second opinions review via a dedicated line.
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10 of 12 outlets skipped it: a national three-year research programme evaluates implementation.
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A&E rollout begins
NHS England is expanding Martha’s Rule to every A&E department in England, giving patients, loved ones and staff a way to call a dedicated phone number to trigger an urgent review if a patient’s condition is deteriorating and concerns are not being listened to. The programme is named after Martha Mills, who died aged 13 in 2021 after developing blood poisoning, or sepsis, and the rule was created after her parents, Merope and Paul, changed the culture by creating the rule. The expansion follows a trial at seven trusts, and NHS England said the nationwide rollout should be complete by March 2028 after the eight-month pilot in emergency departments.
NHS England said the pilot involved 69 calls to dedicated Martha’s Rule phone numbers, including calls relating to acute deterioration following an urgent clinical review. NHS England said in some cases those calls led to a patient having immediate surgery or being transferred to intensive care.
What a call triggers
Prof Aidan Fowler, national director of patient safety at NHS England, said a Martha’s Rule call would mean a patient receives an "appropriate response", for example a senior nurse or a member of the critical care outreach team conducting a review of the case. Prof Fowler told the BBC that staff can themselves ask for a review from a different team if they are concerned the appropriate action is not being taken. Health minister Baroness Merron said the initiative is part of "wider efforts to put patient safety at the heart of the NHS" and she said expanding it to A&E would give patients, families and staff another way to speak up when someone’s condition is getting worse.
Matthew Hopkins, director of The NHS Alliance's acute and ambulance network, said NHS leaders welcome the roll out to all hospital A&E departments and waiting rooms following the initial pilot in seven trusts. Healthcare Management Magazine said latest figures for July 2026 show the highest ever monthly total of calls made via Martha’s Rule (1,678) and that since September 2024 to July this year, more than 19,000 (19,177) calls have been made.
Research and wider reach
A national three-year research programme was introduced in July to evaluate how Martha’s Rule is being implemented across NHS hospitals in England, aiming to identify the best ways to ensure patients, families and healthcare staff are heard when they have concerns about a patient’s deterioration. The phased rollout is also expected to extend Martha’s Rule beyond A&E into maternity and neonatal units by March 2028, with the rule already being rolled out in all inpatient wards. The BBC said Prof Fowler described the expansion as building on evidence from adult and children’s wards, where thousands of calls have been made by patients, families and staff to date.
The Guardian said helplines received more than 10,000 calls in the first 16 months after the scheme was introduced in England in 2024, potentially saving 446 lives. The Independent said the eight-month trial across seven hospital trusts resulted in 69 calls, with several patients subsequently receiving urgent surgery or intensive care transfers.