Martha’s Rule expands to A&E across England

What's happened

England is rolling out Martha’s Rule to all emergency departments by March 2028 after successful pilots. The policy, named for Martha Mills, enables patients, families and staff to trigger a rapid care review when deterioration is suspected, with early trials showing some patients undergoing urgent surgery or transfer to intensive care.

What's behind the headline?

Key takeaways

Martha’s Rule has moved from inpatient wards to A&E, with a phased rollout through 2028.
Trials at seven trusts showed calls can prompt urgent actions, including surgery or ICU transfer.
Officials describe the rule as a vital patient-safety lifeline in busy emergency departments.

Risks and questions

Will the expansion sustain the same impact in overwhelmed A&Es?
How will trusts ensure timely reviews without overburdening staff?
What safeguards exist to prevent non-clinical use of the helpline?

Implications for readers

Families will have a clearer channel to raise concerns.
Hospitals will need to scale a rapid-review workflow across settings.

How we got here

Martha’s Rule was introduced after the 13-year-old Martha Mills died in 2021 from sepsis at King’s College Hospital. Her family campaigned for a system allowing rapid reviews when concerns rise, leading to nationwide expansion from inpatient wards to A&E, maternity and neonatal units.

Our analysis

BBC Business: details of rollout and pilot outcomes. The Guardian: context on Martha Mills and expanded coverage. The Mirror: government and NHS England statements on national rollout.

Go deeper

How quickly will A&Es adopt Martha’s Rule in your area?
What changes are expected in maternity and neonatal units by March 2028?
How will trusts handle potential upticks in calls and reviews?