Martha Mills sadly died in 2021, aged 13, after developing sepsis following a pancreatic injury from a cycling accident. She had been admitted to King’s College Hospital in London. Her family raised their concerns about her deterioration, however, they were not listened to, and in 2022 a coroner ruled that Martha would probably have survived if she had been moved to the intensive care unit earlier.

Her parents, Merope Mills and Paul Laity, campaigned tirelessly for changes to patient safety in the NHS, and their campaign led to Martha’s Rule being introduced across hospitals in England.

• Asking patients at least daily if they feel they are getting better or worse, with the response being acted on in a structured way
• All healthcare staff can ask for a review from a different team if their concerns about a patient’s deterioration are not being responded to
• This escalation route will always be available to patients, families and carers, and will be advertised across the hospital

A second opinion is an established process where you can choose to see another healthcare professional following a diagnosis or treatment plan for a medical condition. Martha’s Rule allows a complete review of your or a loved one’s care if you feel concerns about deterioration are not being acted upon.

Scotland is beginning to use Martha’s Rule, Northern Ireland is considering adopting it, and Wales has a similar scheme called Call4Concern.

The aim is simple: families should never feel powerless when they are worried about a mother or baby.

In June 2026, the Government committed to rolling out Martha’s Rule across all maternity and neonatal settings in England, in response to the serious failings outlined in the Ockenden review of maternity services at Nottingham University Hospitals NHS Trust. This follows successful pilots in 15 maternity and neonatal settings.

The rollout is still under way, so availability currently varies between hospitals. There is not yet a dedicated Martha’s Rule phone number for maternity settings, in the way there is for A&E and hospital wards. For each hospital, you need to ask staff how Martha’s Rule works there and how to request a review – the hospital should be able to tell you how to do this.

It is important that the rapid review is carried out by a clinician with the right expertise. In a maternity setting, ask for the review to be carried out by an obstetric specialist, so that the person reviewing a mother or baby has the appropriate expertise to review their care.

If you feel a mother or baby’s condition is getting worse, you are worried something isn’t right, or you feel your concerns are not being addressed, don’t be afraid to speak up. Tell your midwife or maternity team, and ask for a rapid review if your concerns are not being acted on.

Martha’s Rule is being rolled out to every A&E department in England, including waiting rooms, following a successful pilot in seven NHS trusts.

If you take your baby into A&E and you are worried that they are getting worse, and you don’t feel your concerns are being acted on, you can call the hospital’s dedicated Martha’s Rule phone number to request an urgent review of your baby’s care. You can find the number by asking a member of staff or by checking the hospital’s website.

Because babies are not small adults, it is important to ask for the review to be carried out by a paediatrician – they are the specialists in the care of babies and children. Every call triggers an urgent review by a medical team that is independent of the team looking after your baby.

The rollout to all A&E departments in England will be complete by March 2028. If your local A&E does not yet have a Martha’s Rule number in place, tell staff immediately if you are worried that your baby’s condition is getting worse.

• Department of Health and Social Care, NHS England. Martha’s Rule extended to all maternity services [Internet]. GOV.UK. 2026 Jun 24 [cited 2026 Sep 15]. Available from: https://www.gov.uk/government/news/marthas-rule-extended-to-all-maternity-services
• BBC News. Martha’s Rule rolled out at every A&E department in England [Internet]. BBC News. 2026 Sep 22 [cited 2026 Sep 24]. Available from: https://www.bbc.com/news/articles/c6lyep7l7qppo
• BBC News. Martha’s Rule rolled out to all acute hospitals in England [Internet]. BBC News. 2024 [cited 2026 Sep 15]. Available from: https://www.bbc.co.uk/news/articles/c8e1zw28766o
• NHS England. Martha’s Rule [Internet]. NHS England. 2026 [cited 2026 Sep 15]. Available from: https://www.england.nhs.uk/patient-safety/marthas-rule/
• NHS England. Martha’s Rule: core standards [Internet]. NHS England [cited 2026 Sep 24]. Available from: https://www.england.nhs.uk/long-read/marthas-rule-core-standards/