A phone call can now trigger an emergency medical review in any hospital in England — and the system built to make that happen has already helped save hundreds of lives.

  • 446 lives potentially saved in the scheme's first 16 months
  • 10,000+ calls made to Martha's Rule helplines since the 2024 launch
  • 1,678 calls in July 2026 alone, the highest monthly total on record
  • March 2028 the target date for the full national rollout to A&E

Named After a 13-Year-Old

Martha's Rule is named for Martha Mills, a 13-year-old who died in 2021 from sepsis after a bicycle accident. A coroner later found she would probably have survived if she'd been moved to intensive care at King's College Hospital in London when her condition began deteriorating. Her parents, Merope Mills and Paul Laity, spent years campaigning for a system that would let patients and families demand a second opinion — and be heard.

That campaign became policy. The rule gives patients, loved ones, and NHS staff the right to call a dedicated helpline and request a rapid review whenever they believe a patient is deteriorating and isn't being taken seriously.

How It Works in the ER

Since launching across acute wards and maternity units, the rule has already logged more than 10,000 calls, with thousands of patients moved to intensive care, given medication, or otherwise helped as a direct result. NHS England now says it is expanding the system into every accident and emergency department in the country, including waiting rooms — one of the highest-pressure, highest-risk environments in a hospital.

An eight-month pilot across seven NHS trusts tested whether the model could work in the chaos of a busy A&E. During that pilot, 69 calls were made, with some patients transferred to intensive care or receiving urgent surgery as a result.

"Martha's rule is already having a transformative effect in making our acute care even safer, and by expanding it into A&Es, we are giving even more patients, their families and NHS staff a critical new lifeline to help improve care and save more lives."

That's Prof Aidan Fowler, NHS England's director of patient safety, describing why officials are confident the model translates from quiet wards to a Friday-night emergency room.

What Comes Next

The rollout to every A&E in England will happen in phases, with NHS England targeting completion by March 2028. Health minister Gillian Merron framed the expansion as part of a broader shift in how the health service treats patient and family concerns. "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," she said.

Details on how the system works and where it currently operates are published on the NHS England Martha's Rule page, and full reporting on this week's expansion is available via The Guardian. For a family in a crowded waiting room at 2 a.m., the change amounts to a simple guarantee: if something feels wrong, there is now a number to call, and someone has to listen.