Martha Mills was 13 years old when she died needlessly. She sustained a pancreatic injury from a bike accident and then developed sepsis. An inquest found that if she had been moved to intensive care sooner, she would have likely survived.
Her mother, Merope Mills, says senior NHS doctors did not listen to her about Martha’s deteriorating condition, that she trusted the clinicians against her instincts, and that they “managed” her.
Today, on the day Martha would have been 16, a report from the Demos think thank, supported by Tortoise, calls for a new rule to be introduced giving families and carers the automatic right to an urgent second opinion if they feel a patient’s condition is deteriorating and they are not being listened to.
Martha’s Rule, based in part on a similar proposal adopted in Australia, would “formalise the idea of asking for a second opinion, from a different team outside team currently looking after you,” Mills told the BBC today. “It shouldn’t be a problem and it shouldn’t involve confrontation.”
Bad communication from doctors has been a persistent problem in the UK’s healthcare service. A 2019 study of patients who had experienced a “safety incident” while in hospital found that 22 per cent of patients identified poor communication between staff and patients as the leading cause of the problem.
The call is likely to be opposed by some doctors who feel they are already overstretched by budget cuts and waiting lists. But around the world, hospitals have already introduced schemes giving patients and their loved ones an automatic right to request a review from a separate team of clinicians:
– Condition H(elp) is a system devised by the University of Pittsburgh. It was launched at its medical centre after Josie King died in 2001 due to hospital errors and poor communication. It allows direct calls to be made to a rapid response team using an in-hospital 911 call. Reviews show no overuse or abuse of the policy and that the system helped cut cardiac arrests by 25 per cent at one hospital in Jacksonville.
– Ryan’s Rule: In Australia, Queensland Health developed a system following the death of Ryan Saunders from an undiagnosed streptococcal infection, allowing families to call a dedicated phone number and ask for a Ryan’s Rule Review. A nurse then visits and assists.
– Call 4 Concern is a policy adopted by some hospitals in the UK. It’s an escalation system that lets patients call or bleep a hospital’s Critical Care Outreach Team if they are concerned about a change in their condition which has not been recognised. Posters advertising the scheme are prominent around the hospital, including on every bedside locker. A 2019 review of referrals in the Royal Berkshire found that out of 534 calls, a fifth of cases required significant interventions.
Gillian Keegan, the education minister, was asked as a government representative this morning if the proposal for a Martha’s Rule would be adopted. She was non-committal.
Photograph courtesy of Merope Mills