Mother hopes Martha’s rule will ‘upend hierarchy’ on hospital wards

<span>Martha’s rule gives patients and their families access to a rapid review from an independent critical care team.</span><span>Photograph: Peter Byrne/PA</span>
Martha’s rule gives patients and their families access to a rapid review from an independent critical care team.Photograph: Peter Byrne/PA

The mother of a 13-year-old girl who died of sepsis has said she hopes Martha’s rule, which gives patients and their families the right to a second medical opinion, will “upend” the “hierarchy” on hospital wards.

Merope Mills, who campaigned with her husband, Paul Laity, to give families more say regarding care following the death of their daughter Martha, also called for a “mutual respect” between patients and doctors.

More than 140 NHS sites in England have agreed to implement Martha’s rule, a patient safety initiative that will give patients and their families round-the-clock access to a rapid review by an independent critical care team from elsewhere in the hospital if they feel their health, or that of a family member, is deteriorating and they are not being listened to.

Martha died of sepsis in 2021 after receiving a pancreatic injury when she fell off her bike. Mills and Laity raised concerns about their daughter’s health a number of times but these were brushed aside.

Related: ‘We had such trust, we feel such fools’: how shocking hospital mistakes led to our daughter’s death

A coroner ruled the teenager would most likely have survived if doctors had identified the warning signs of her rapidly deteriorating condition and transferred her to intensive care earlier.

Speaking at NHS ConfedExpo on Wednesday, Mills, an executive editor at the Guardian, said: “My big thing is, I think we need to be more equal.

“It’s a very unequal place, a hospital ward, and there’s hierarchy and it’s very steep and it’s very strict. And, you know, when I first started talking about that, I sort of thought the nurses were at the bottom of the hierarchy.

“And I refer to that because they didn’t feel that ability to speak up in Martha’s case. But I’ve actually come to realise that the people at the bottom of the hierarchy are the patients.

“They are the ones with the least power and I just would like to upend that and just have a sense of mutual respect between doctor and patient.”

It was announced in February that Martha’s rule was expected to be rolled out in at least 100 NHS trusts in England from April. Last month, NHS England revealed 143 hospital sites would implement the rule, which would be available 24/7 and advertised on posters and leaflets throughout hospitals.

Aidan Fowler, the national director for patient safety at NHS England, thanked NHS trusts for the “amazing response” to the initiative. “We aimed at 100 because it felt like a really good start,” he said. “I knew when we had 10 people apply within the first hour that we were going to exceed that. “And we’ve had 143 sites and we’ve still got people stepping forward. So that’s an amazing response. So there is enthusiasm out there.”

Fowler said a pilot model was being developed with the teams that had signed up. “There are some basic principles that we know about, that have been talked about, but there’s an enormous amount of detail that we’re working through together.

“So it’s manifesting concerns about adult critical care teams going to see children, and what can we do better in the paediatric sphere. How do we introduce this in maternity has been mentioned, or the emergency department.

“Our aim is not to enforce a model on the system, but to develop a model that makes sense to the system.

“We’ll all be doing it once we’ve got a model that we think works. And once we can then develop the ideal model, we will be doing this.”