The NHS has announced which 143 hospitals will test and roll out Martha's Rule in its first year.

Martha's Rule will allow patients and families to seek an urgent review if their or their loved one’s condition deteriorates and they are concerned this is not being responded to.

The scheme is named after Martha Mills, who died from sepsis aged 13 in 2021. Her family's concerns about her deteriorating condition were not responded to and she was not escalated to intensive care.

NHS England is working with Martha's parents to develop materials to advertise and explain the initiative in hospitals.

Initially the target was to enrol at least 100 sites, but due to significant interest from frontline clinicians this was expanded. 

The first phase of the programme will be in place at 143 locations across the country by March 2025. An evaluation of these sites will inform proposals for Martha’s Rule to be expanded further across all acute hospitals, subject to future government funding.

Martha's Rule will be made up of three components - firstly escalation process will be available 24/7 at all the 143 sites, advertised throughout the hospitals on posters and leaflets, enabling patients and families to contact a critical care outreach team that can swiftly assess a case and escalate care if necessary. NHS staff will also have access to this same process if they have concerns about a patient’s condition.

The final component is that clinicians at participating hospitals will also formally record daily insights and information about a patient’s health directly from their families, ensuring any concerning changes in behaviour or condition noticed by the people who know the patient best are considered by staff.

Professor Sir Stephen Powis, NHS national medical director, said: “Rolling out Martha’s Rule to over 143 NHS sites in this first phase will represent one of the most important changes to patient care in recent years, and we are pleased to have seen such interest from hospitals right across the country, all thanks to the moving and dedicated campaigning by Martha’ parents, Merope and Paul.

“That is why today is such an important milestone, with the NHS outlining the 143 sites where this major patient safety initiative will be rolled out later this year, allowing staff, patients and families to immediately raise concerns and bring about an escalation in care in an easily recognisable and fast way.

“The inclusion of daily insights from families about their loved ones’ condition within patient records is also a really significant step and will help staff identify changes and deterioration using insights from those who know the patient best. While thankfully the need for escalation of care will hopefully only be needed in a limited number of cases, this three-step safety net has the opportunity to truly transform patient care and safety.”

NHS national patient safety director and senior responsible officer for Martha’s Rule, Dr Aidan Fowler, said: “Working closely with Martha’s parents and colleagues across the NHS over the last few months on this rollout, I am in no doubt this programme will deliver clear change and it has been so encouraging to see how many hospitals have shown interest in being part of delivering these all-important patient safety measures this year.

“With new processes that enable both patients and staff to raise concerns if they see someone’s condition worsening, and the inclusion of patients and their loved ones’ insights in medical records, these measures can help us better identify and manage deterioration as part of wider work, which is a key priority for us and will no doubt lead to improvements in the care patients receive.”

The full list of hospitals is available on NHS England's website.