On what would have been Martha Mills’ 18th birthday, every acute hospital in England has enacted a new patient safety measure known as Martha’s Rule—a move hailed as transformative for the National Health Service (NHS) and a landmark moment for families across the country. The rollout, announced by NHS England on September 4, 2025, follows a groundswell of campaigning led by Martha’s parents, Merope Mills and Paul Laity, after their daughter’s tragic death from sepsis in 2021.
Martha, just 13 at the time, died at King’s College Hospital in London after her family’s repeated pleas for more urgent care were dismissed. A coroner later concluded that Martha would likely have survived had she been transferred to intensive care sooner and given appropriate treatment. The failings in her care, and the subsequent inquest, ignited a movement that has now reshaped how hospitals respond to patient and family concerns.
Martha’s Rule introduces a dedicated telephone helpline in every acute NHS hospital in England. This helpline allows families, carers, and even hospital staff to request an urgent second opinion from a critical care team if they believe a patient’s condition is deteriorating and their concerns are not being heard. The initiative aims to break down barriers between clinicians and families, fostering what Merope Mills describes as “a different, more equal kind of doctor-patient relationship.”
Since its pilot launch in April 2024 at 143 hospital sites, Martha’s Rule has already demonstrated its life-saving potential. According to NHS England data, nearly 5,000 calls were made to the helpline between September 2024 and June 2025. Of these, almost three-quarters—about 71.9%—came from families seeking help for their loved ones. The outcomes have been striking: 241 potentially life-saving interventions were recorded, 720 calls led to changes in care such as new antibiotics or medicines, 794 addressed delays in investigations or treatments, and 1,030 resulted in improved communication or discharge planning.
“We feel Martha’s absence every day,” her parents said in a statement marking her birthday. “But at least Martha’s rule is already preventing many families from experiencing something similar. The figures prove that lives are saved when patients and families are given power to act on their suspicions when they feel doctors might have got it wrong and their voice isn’t being heard.”
The scheme is not just for families. Hospital staff—including those in junior roles—are also empowered to request an independent review if they have concerns about a patient’s care. Clinicians now record daily insights from families about a patient’s health, ensuring that the people who know the patient best are part of the decision-making process. The escalation process is available 24/7 and is advertised throughout hospitals to maximize awareness and accessibility.
Health Secretary Wes Streeting, speaking to multiple outlets, praised the Mills family’s “tireless campaigning,” calling the rule “a lasting legacy that is already having a potentially life-saving impact across England.” He added, “No family should ever have to go through what Merope and Paul Mills endured when they lost Martha, but her parents’ tireless campaigning has created a lasting legacy that is already having a potentially lifesaving impact across England. Martha’s rule puts patients and families at the heart of their care.”
The sentiment is echoed by NHS England’s national medical director, Professor Meghana Pandit, who described Martha’s Rule as having “a transformative impact on the way hospitals are able to work with patients and families to address deterioration or concerns about care.” She thanked the Mills family for their advocacy and clinical staff nationwide for swiftly implementing the rule. Rachel Power, chief executive of the Patients Association, called the nationwide rollout “a landmark moment for patient safety.”
The story behind Martha’s Rule is a sobering reminder of what can happen when patient voices are not heard. In 2021, Martha was admitted to King’s College Hospital after a bicycle accident. She developed sepsis, and despite her parents’ repeated concerns, her deteriorating condition was not escalated to intensive care in time. The 2022 inquest found that had Martha been transferred sooner and given the right treatment, she probably would have survived. The Mills family’s campaign has since become a rallying point for patient safety advocates across the UK.
One Today programme listener wrote to Merope Mills, “I followed Martha’s story on Radio 4, never thinking anyone I knew would need to use Martha’s rule. Thank you from the bottom of my heart for everything you have done and are doing to raise awareness and to empower people in an environment where we all naturally feel intimidated.”
While the rollout is a milestone, campaigners and officials alike acknowledge there is more to do. Merope Mills and Paul Laity have called for Martha’s Rule to be extended across the UK, noting it is “unfair” that patients in Scotland, Wales, and Northern Ireland do not yet have the same access. The Welsh Government is moving ahead with a similar scheme, Call4Concern, expected to reach all hospitals by the end of 2026. Scotland is piloting Martha’s Rule in several hospitals and considering a nationwide approach, while Northern Ireland’s Department of Health is monitoring the impact in England but has no immediate plans for adoption.
Health Secretary Wes Streeting has also pointed out the relevance of Martha’s Rule for maternity care, referencing “similar experiences where mothers were not listened to in maternity services.” He stressed the importance of listening to patients—especially women—at the right time and place to prevent harm and, in the worst cases, fatalities.
Clinical staff on the ground have welcomed the change. Amy Blakemore, a matron in a sepsis and outreach response team, highlighted the vital role of families and carers: “Any concerns in relation to their child’s deteriorating condition that they feel are not being listened to can initiate Martha’s rule and they can get an independent review.”
As the NHS continues to evaluate the program, there are plans to consider expanding Martha’s Rule into hospitals providing longer-term care, mental health trusts, and community settings. For now, the focus remains on acute hospitals, where the need for rapid escalation can be most urgent.
For families like the Mills, Martha’s Rule represents both a tribute and a tool. “The reality is we are all, as I know, one disaster away from it being about us,” Merope Mills reflected. “It could be your mother, it could be your sibling, God forbid it could be your kid who one day needs this.”
With thousands of calls already made and hundreds of lives potentially saved, Martha’s Rule is reshaping the culture of English hospitals—reminding everyone that, sometimes, the difference between tragedy and survival is simply being heard.
