Martha’s Rule: raising concern’s about a child’s health getting worse in hospital

What is Martha’s Rule?

Martha’s Rule is a patient safety initiative introduced by NHS England. It supports patients and families by giving them access to a review if they feel that the child is deteriorating or their concerns are not being listened to.

We recognise that parents and carers know their child best and may notice small changes before they show up in routine observations. Telling us about these changes can help us detect deterioration early, so that we can take action.

When should I use Martha’s Rule?

Children and their parents or carers can call the Martha’s Rule phone number if:

• you are worried that a child’s condition is getting worse
• a noticeable change in the child’s clinical condition occurs, and you feel that colleagues are not listening to your concerns
• You feel that something is not right.

Call 07785 655 478 where your call will be answered by one of the Clinical Site Managers.

If you do not have access to a phone, please ask one of our colleagues to use a ward phone.

Martha’s Rule is a patient safety initiative. To report concerns relating to parking, food, hospital accommodation or for any general issues please speak to the Ward Manager, Nurse in Charge or our PALS team.

Who are our Clinical Site Managers?

The Clinical Site Managers are a senior registered nurse who directs and coordinates the daily operational flow of the hospital. They ensure safe staffing, manage patient flow and promote positive patient outcomes and enhance the patient’s journey in hospital.

Responding to your call

When the Clinical Site Manager receive your call, they will ask a series of questions to understand your concern including:

• Patient’s full name and date of birth
• Ward and bed number
• A brief description of your worried and concerns
• Your relationship to the child and contact details

All calls to this number will be assessed and where appropriate the Clinical Site Manager will visit the patient on the ward.

This service is available 24 hours a day, 7 days a week. If your call is not answered, please leave a voicemail with the above information.

How are we putting Martha’s Rule into place?

Whilst your child is at Sheffield Children’s, we regularly check on their vital signs and other important health measurements. Sometimes we may need to wake your child to do some of these checks.

How often we do these checks depends on your child’s individual condition and needs.

As well as this, we will ask your child if they are feeling better or worse using our Patient Wellness Questionnaire to monitor any unexpected changes in their condition. We will do this every day. Sometimes we will do this more than once per day.

Martha’s story

Martha Mills died in 2021 after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling off her bike. Martha’s family’s concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that Martha, aged 13, would probably have survived had she been moved to intensive care earlier.

Martha’s Rule makes sure that patients and those who know them best are listened to – and that concerns about clinical deterioration are taken seriously and acted upon promptly.

For more information about Martha’s Rule, please visit the NHS England website.