Martha’s rule may have saved 400 lives so far in England, figures show

Exclusive: System brought in after death of 13-year-old is helping ‘transform culture’ of NHS, says patient safety director

More than 400 lives may have been saved as a result of Martha’s rule, which lets NHS patients request a review of their care, official figures reveal.

Helplines received more than 10,000 calls in the first 16 months of the scheme after its introduction in England in 2024, according to data seen by the Guardian. Thousands of patients were either moved to intensive care, received drugs they needed or benefited from other changes as a direct result of the calls.

The system is named after Martha Mills, 13, who died in 2021 from sepsis after a bicycle accident. A coroner found she would probably have survived if she had been moved to the intensive care unit at King’s College hospital in London when she began deteriorating.

Martha’s rule helplines received 10,119 calls between September 2024 and December 2025 from patients, relatives or staff who were worried about care, the figures show. That led to 446 people receiving improvements to their care that may have saved their life.

One in three calls (3,457) identified a rapid worsening of a patient’s condition, helping raise the alarm more quickly and enable crucial interventions to be made. The NHS England data shows 1,885 patients had their treatment changed as a result.

In addition, about 6,000 calls had addressed clinical, communication or coordination concerns, which led to “meaningful improvements” in care or navigating the healthcare system for patients and their families, health officials said.

The initiative is the direct result of pressure put on politicians, NHS bosses and doctors after Martha’s parents, Merope Mills and Paul Laity, told the story of what happened to their daughter, who would have turned 18 last September if she had lived.

Martha’s rule is now in operation in every acute hospital in England.

Mills, a senior editor at the Guardian, said: “The more data that is gathered, the clearer it becomes that Martha’s rule is having a hugely positive effect. Apart from the lives saved, over a third of the calls have led to a marked improvement in care.

“The process is not being overused and has obviously met a need, giving patients and families real agency. We look forward to its thorough implementation in maternity departments and call for its rapid introduction in Wales and Scotland.”

The scheme gives patients, their loved ones and NHS staff the right to ask for a different medical team to examine the care being provided and recommend changes.

Patients at hospitals involved in the programme have 24/7 access to a critical care team of doctors and nurses from elsewhere in the building, who specialise in the care of patients who are deteriorating and who will come and assess the situation.

Aidan Fowler, NHS England’s director of patient safety, said: “Martha’s rule is already helping to save lives and transform the culture of the NHS. These figures show that Merope and Paul’s tireless campaigning and the hard work of staff are helping the NHS listen to families more effectively and shows that when concerns are raised, hospital teams are ready to respond.”

Responding to the data, Wes Streeting, the health secretary, said Mills and Laity had turned “unimaginable grief” into “lasting change”.

“Martha’s rule is making sure the NHS listens to patients and their families when it matters most, with each call potentially resulting in a life-saving intervention,” he said.

“I am determined that Martha’s legacy continues to grow through pilots in maternity wards. This is all part of our plan to make sure that patient safety is at the very heart of the NHS and that each and every family gets the compassionate care they expect and deserve.”