Technology and Science22 September, 20262 min read
NHS England Rolls Out Martha’s Rule To Every A&E In England By March 2028
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NHS England extends Martha's Rule to all A&E departments and waiting rooms by March 2028. Patients, families and staff have 24/7 access to trigger clinical review via a phone line.
A&E expansion begins
NHS England is expanding Martha’s Rule to every A&E department in England, with the nationwide rollout expected to be complete by March 2028 after a pilot at seven trusts. Professor Aidan Fowler, national director of patient safety at NHS England, said the expansion would give families and NHS staff “a critical new lifeline” to help improve care and save more lives. The rule is named after Martha Mills, who died aged 13 in 2021 after developing blood poisoning, or sepsis, and her family’s concerns were not listened to.
The scheme lets patients, loved ones and staff in A&E units call a dedicated phone number to trigger an urgent review if a patient’s condition is deteriorating and they are concerned this is not being taken on board. The pilot data cited by NHS England included 69 calls to dedicated Martha’s Rule phone numbers during an eight-month period, and some calls led to urgent surgery or transfers to intensive care.
Voices back the rule
Baroness Merron said the initiative is part of “wider efforts to put patient safety at the heart of the NHS,” and she framed the A&E expansion as a way to ensure concerns are acted on quickly. Elliott Paterson, from Cheltenham, told the BBC that he “truly believes” Martha’s Rule saved the life of his 67-year-old father, Chris, at Gloucester Royal Hospital after he broke four ribs. Jason Watkins praised the rollout, saying Martha’s Rule was already “making a difference on the wards” and adding that it “enables a parent to have a voice”.
NHS England also said early testing showed Martha’s Rule could work well in busy A&Es without staff being overwhelmed, and Fowler said: “Actually people have used it very sensibly.” Healthcare Today said a national three-year research programme was introduced in July to evaluate how Martha’s Rule is being implemented across NHS hospitals in England.
Numbers and what’s at risk
NHS England said July 2026 recorded the highest-ever monthly total of calls made via Martha’s Rule, with 1,678 calls, and it said that from September 2024 to July this year more than 19,000 calls had been made. The Guardian reported that in the first 16 months of the scheme after its introduction in England in 2024, helplines received more than 10,000 calls and “potentially saving 446 lives”. Wired Gov said the A&E expansion adds safeguards in A&E waiting rooms so that patients can trigger an urgent review if acute deterioration occurs while they are in the department.
The policy is also expected to extend beyond A&E, with hospitals expected to extend Martha’s Rule to maternity and neonatal units by March 2028 as part of a phased implementation. NHS England’s pilot findings were described as showing Martha’s Rule could work alongside existing clinical procedures in busy and fast-paced A&E environments without requiring additional clinical staff.