Children’s Inpatient Ward – Martha’s Rule: early detection of deterioration

What is Martha’s Rule?

Since May 2024, NHS acute care providers have been testing and implementing Martha’s Rule, to support the early detection of deterioration by ensuring the concerns of patients, families, carers and staff are listened to and acted upon.

Martha’s story

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.

The three core components of Martha’s Rule:

1. Patients will be asked, at least daily, about how they are feeling, and if they are getting better or worse, and this information will be acted on in a structured way.
2. All staff will be able, at any time, to ask for a review from a different team if they are concerned that a patient is deteriorating, and they are not being responded to.
3. This escalation route will also always be available to patients themselves, their families and carers and advertised across the hospital.

New: 24 November 2025

Launch of Martha’s Rule phone line: 07975 235844 (Children’s inpatients)

Patients, their families and carers will be able to call the on call Paediatric team directly if they have concerns about patient deterioration which they feel are not being addressed by the ward team.

Component 3: Empowering patients, families and carers

Martha’s Rule actively encourages patients, their families and carers to tell staff if they are worried a health condition is getting worse. They may notice small changes that could be early warning signs of deterioration before they show up in routine measurements.

This service is now available on the children’s and young persons in-patient ward at Bradford Royal Infirmary – Ward 30.

If, after speaking to the care team, the patient or their family/carer remain worried and feel their concerns are not being addressed, they can call a dedicated number for a rapid review.

Martha’s Rule phone line: 07975 235844 (Children’s inpatients)

This is advertised at the entrance and throughout the ward area with information on the Trust’s external website.

Further information

• Martha’s Rule, NHS England
• Martha’s Rule, BTHFT

Please contact the Improvement team – improvement@bthft.nhs.uk – if you would like to know more.