Martha’s Rule to be extended to A&E departments in England
Patients and families in Birmingham will be given a clearer route to request an urgent second opinion in hospital A&E departments, as Martha’s Rule is expanded across England.
Martha's Rule has been expanded to A&E departments across England, giving patients, loved ones and NHS staff 24/7 access to an urgent review if they are worried someone’s condition is getting worse and feel their concerns are not being listened to.
It was introduced after the death of 13-year-old Martha Mills, who developed sepsis while being treated at King’s College Hospital NHS Foundation Trust in south London in 2021. A coroner later ruled she would probably have survived if she had been moved to intensive care sooner.
Martha’s parents, Merope Mills and Paul Laity, have said their concerns about her deteriorating condition were repeatedly dismissed.
In reaction to the news that Martha's Rule would be extended, Seniz Greenhalgh, who's Solihull-based mother died after their concerns were ignored, has said: "it's one of the best things I have heard in the last five years."
Seniz Greenhalgh's mother, Sevinc Ulkueri, died in Heartlands Hospital, Birmingham, in March 2021, after delays to treatment led to a perforated bowel and sepsis.
In an investigation, the Parliamentary and Health Service Ombudsman (PHSO) concluded that her death could have been prevented, and that earlier diagnosis and treatment would have saved her life.
"We knew she was getting worse because we were speaking to her on the phone ourselves," said Ms Greenhalgh.
"Many times I tried to make a phone call to the ward and tried to explain to them: my mother's problem is in her stomach. She's telling me her stomach is hurting.
"We were being dismissed. But with Martha's rule, I think this is going to come to a stop.
"I think things are going to tremendously improve and I think we will be able to avoid these devastating losses."
How is Martha's Rule being extended?
Under the latest plans, the NHS will extend Martha’s Rule into busy A&E departments, alongside its rollout across inpatient wards. It means people in emergency departments will be able to call a dedicated phone number to trigger a rapid review of care.
The phased rollout is expected to be completed by March 2028, with hospitals also due to extend the scheme to maternity and neonatal units.
NHS England said a pilot in seven trusts found the system could work safely in A&E. During an eight-month trial, 69 calls were made, with some patients later needing urgent surgery or a transfer to intensive care.
Professor Aidan Fowler, national director of patient safety at NHS England, said A&Es see “some of our most vulnerable patients” and that being able to raise concerns quickly is “essential”.
He added that Martha’s Rule is already having a “transformative effect” in acute care, and that expanding it to A&E would give patients, families and staff “a critical new lifeline”.
Health minister Baroness Merron said the rule is about making sure patients and their loved ones are heard when they raise concerns.
She said: “Expanding it to A&E will give patients, families and staff another way to speak up when they are worried that someone’s condition is getting worse, ensuring concerns are acted on quickly.”
Latest figures show July 2026 saw the highest monthly number of calls made through Martha’s Rule so far, with 1,678 calls recorded.