The UK government says it would explore implementing Martha’s Rule in English hospitals, making it easier for family, carers and patients to get an urgent second medical opinion.
Martha Mills was 13 when she died needlessly two years ago after a bike accident that injured her pancreas. She subsequently developed sepsis under the care of doctors at King’s College Hospital in London.
Yesterday her mother and the think tank Demos proposed a new rule in her daughter’s name that would ensure an automatic right to a review or second opinion in serious clinical cases, without fear of confrontation with medical staff.
Steve Barclay, the health secretary, said he has asked his department and the NHS to explore Martha’s Rule, citing a similar system in Australia that he said had “saved lives”.
Queensland Health developed a system following the death of Ryan Saunders in 2010 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.
Wes Streeting, the shadow health secretary, told the Today programme today Martha’s Rule “has got to happen” and it was something a Labour government “would deliver”.
Streeting said Labour would move to include Martha’s Rule in the NHS constitution – the written document setting out rights for patients, public and staff – and would “make sure” the rule was displayed across the NHS estate so that “every patient, every family, from every type of background knows their rights and knows how to exercise them”.
An inquest in 2022 found that Martha probably would have survived if specialist doctors at KCH had identified warning signs and moved her earlier to intensive care.
Merope Mills, Martha’s mother, told the BBC yesterday: “The thing that I find most unforgivable, is that they left her so long, she knew she was going to die”. She said Martha told her while lying in bed that “it feels like it’s unfixable”.
Labour’s Wes Streeting also said Labour was looking into other concerns raised by Martha’s family about their daughter’s care, including a “Monday to Friday” work culture.
Martha’s parents had raised concerns with doctors before the 2021 August bank holiday weekend that they were worried she would go into septic shock while many of the doctors would be on call at home.
Although Martha met all the criteria to be transferred to ICU and consultants had discussed her severe sepsis, the duty consultant said, from home, that an ICU doctor should not attend Martha as it would increase her mother’s anxiety.
Mills said she had been “managed” rather than listened to, and felt powerless. “A national expert on sepsis worked just down the corridor in paediatric ICU (intensive care): had he seen her following a review, we know her treatment would have been utterly different,” she told the Press Association.
By the time Martha was transferred to paediatric intensive care on 30 August she had septic shock and was “profoundly unwell … and failed to respond to interventions,” according to Professor William Bernal, who produced a serious incident report on Martha’s death for KCH.
“If a patient and family escalation system such as ‘Martha’s rule’ had existed – and had been clearly advertised around the hospital with posters and stickers – I’m sure I would have used it and it could well have saved Martha’s life,” Mills said.
A 2019 review of the Call 4 Concern policy adopted at the Royal Berkshire NHS trust 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 found that out of 534 calls, a fifth required significant interventions.
Kings College Hospital has admitted mistakes were made. The KCH trust said in a statement that it “remains deeply sorry that we failed Martha when she needed us most”.
The hospital says it has put several measures in place since Martha’s death including sepsis training for all clinical staff. NHS England told the Guardian: “All patients and families are able to seek a second opinion if they have concerns about their care – and, as professional guidance for doctors in England sets out, it is essential that any patient’s wishes to seek a second opinion are respected.”
Photograph courtesy of Merope Mills