Martha’s Rule
Martha’s Rule: Detecting Deterioration
You know yourself or your loved one better than anyone. If you’re worried about a health condition getting worse, talk to us.
What is Martha’s Rule?
We have introduced Martha’s Rule to help spot any unexpected signs of deterioration early and give you the right to request a rapid review if you’re worried that your or your loved one’s condition is getting worse.
You may notice small changes before they show up in our routine measurements. These changes could be early warning signs of deterioration.
How we monitor patients
While someone is in hospital, we regularly check their vital signs and other important health measurements. The frequency of these checks will depend on the patient’s individual condition and needs. Sometimes we may need to wake patients to do these checks.
In addition, we will also ask at least daily if patients are feeling better or worse. This is to monitor any unexpected changes in their condition.
What to do if you’re worried
- First, speak to the team caring for you or your loved one
- If, after speaking to the care team, you remain worried and feel your concerns are not being addressed, call Switchboard and ask for the Critical Care Outreach team for a rapid review.
Your call will go to a different team in our hospital, who specialise in the care of critically ill patients. They will work with your or your loved one’s care team to arrange any treatment needed or further review.
The service is available 24 hours a day, seven days a week.
Our commitment
We will regularly ask for your views and take your concerns seriously. We see you as a partner in the care we are providing and want you to raise any worries and concerns you may have.
Difference between Martha’s Rule and second opinion
Martha’s Rule allows hospital inpatients and their families to seek a rapid review if their condition, or the condition of a loved one, is deteriorating.
A second opinion is when you would like to see another consultant to discuss any diagnosis or treatment.
Martha Mills
Martha Mills died in 2021 after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling off her bike. Martha’s family’s concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that Martha, aged 13, would probably have survived had she been moved to intensive care earlier.
Patients and families
What is Martha’s Rule?
- Martha’s Rule helps spot early warning signs of deterioration.
- As well as regular patient checks, hospital staff will ask at least daily if patients are feeling better or worse to monitor any unexpected changes in their condition.
- Martha’s Rule gives patients and their loved ones the right to request a rapid review with a specialist clinical team if you’re worried about a health condition getting worse.
- The service is available 24 hours a day, 7 days a week through our dedicated phone lines:
- For Bedford call 01234 355122 and ask the operator to put you through to the Critical Care Outreach Team
- For Luton & Dunstable University Hospital call 01582 491166 and ask the operator to put you through to the Critical Care Outreach Team
Patient and family expertise matters
- You know yourself or your loved one better than anyone. If you’re worried about a health condition getting worse while in hospital, talk to us.
- You may notice small changes before they show up in our routine measurements. These changes could be early warning signs of deterioration.
- Telling our staff about these changes can help us to detect deterioration early so we can take action to prevent more serious health problems.
- We will regularly ask for your views and take your concerns seriously. We see you as a partner in the care we are providing and want you to raise any worries and concerns you may have.
If you would like to leave feedback about your experience of Martha’s Rule, please visit the Trust’s IQVIA feedback form.
For more information on Martha’s Rule, visit the NHS England website.
To see the Trust’s Martha’s Rule media release, please visit our Latest News page.