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Rollout of Martha’s Rule: implications for care
  1. Jan Dudley1,
  2. Stephen W Turner2,
  3. Michael McKean3,
  4. Jonathan Bamber4,
  5. C Ronny Cheung5
  1. 1Paediatric Nephrology, Bristol Royal Hospital for Children, Bristol, UK
  2. 2Department of Child Health, University of Aberdeen, Aberdeen, UK
  3. 3Great North Children's Hospital Paediatric Respiratory Unit, Newcastle Upon Tyne, Tyne and Wear, UK
  4. 4R&QI, RCPCH, London, UK
  5. 5General Paediatrics, Evelina London Children's Hospital, London, UK
  1. Correspondence to Dr Jan Dudley; jan.dudley{at}uhbw.nhs.uk

https://doi.org/10.1136/archdischild-2024-327406

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    Martha’s Rule stipulates the right of a patient on a hospital ward, or their family or carer or staff to request a rapid review from a critical care outreach team in the event of a suspected deterioration or serious concern.1 This National Health Service (NHS) England initiative is not paediatric specific and may ultimately include all four UK nations. This article aims to provide a background to Martha’s Rule and discuss some of the issues that child health services might face when delivering Martha’s Rule.

    Martha

    Martha Mills died in 2021 at the age of 13 years. Having been admitted to the hospital with pancreatic trauma, her parents voiced concerns that her condition was deteriorating, but the transfer to the paediatric intensive care unit (PICU) did not occur in time to save her. The coroner ruled that Martha would probably have survived had she been transferred sooner to intensive care.1

    Patient/carer escalation in healthcare

    Patients, parents and carers already have a right to ask for a second opinion, but this is not legally binding. The National Institute of Health and Care Excellence (NICE) guidance on patient experience (in adult NHS services) recommends that healthcare staff should ‘ensure the patient knows that they can ask for a second opinion from a different healthcare professional’.2 The General Medical Council states that doctors should respect patients’ right to seek a second opinion. Martha’s case illustrates that patients and …

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    Footnotes

    • X @jandudley17, @cheungronny

    • Contributors All authors (JD, SWT, MM, JB and CRC) have contributed to this viewpoint. JD drafted the brief report, and other authors made constructive comments based on their experiences in the area. JD is guarantor.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.