According to figures released by NHS England, 12,301 calls were made to Martha's Rule helplines in the first 18 months, between September 2024 and February 2026. The data shows that 4,047 of those calls helped identify a deteriorating patient – roughly one in three of all calls – and 524 patients were subsequently moved to intensive care or high-dependency units. Martha's Rule was established after the death of 13-year-old Martha Mills in 2021.
She died of sepsis at King's College Hospital NHS Foundation Trust. A coroner ruled she would have survived if medics had recognized warning signs and transferred her to intensive care sooner. The rule gives families formalized, 24/7 access to a second opinion and is advertised in hospitals.
It is hugely encouraging for us that 1,000 clinically-trained staff have already used Martha’s rule.
Hospital staff made 1,080 of the calls that identified a deteriorating patient, NHS England reported. Overall, staff placed 1,781 calls to the helplines, and more than 1,500 NHS staff have invoked the rule, according to NHS England, showing that the helpline is a resource for clinicians as well as families. Almost three-quarters (72%) of all calls came through the family and carer escalation process, NHS England said, with a third of those related to acute deterioration.
Nearly 3,000 non-deterioration calls addressed clinical issues such as delays in medication or investigations, the health service added. Merope Mills and Paul Laity, Martha's parents and campaigners for the rule, said it was 'hugely encouraging' that 1,000 clinically trained staff had sought a review. They added that the figures showed 'clear evidence that issues such as hierarchy, poor communication and some doctors' resistance to being challenged affect hospital care every day' — factors they said were crucial to why Martha lost her life.
This is also clear evidence that issues such as hierarchy, poor communication and some doctors’ resistance to being challenged affect hospital care every day. Such factors were crucial to any explanation as to why Martha lost her life.
Of the total calls, 534 led to life-saving interventions, such as transfer to a specialist ward, according to NHS England. ' NHS England said the number of hospitals that have implemented Martha's Rule has not been disclosed, and it remains unclear how many calls were made by patients themselves versus family members. The long-term survival rate of patients identified through the scheme is also not yet known, officials added.
We welcome a public conversation about healthcare that explores culture and goes beyond the real problem of stretched resources. And we are very grateful to all those NHS staff who have worked so hard to introduce Martha’s rule.
Martha’s rule is already having a lifesaving impact and these figures show the r
It was 'hugely encouraging' that 1,000 clinically trained staff had sought a review.
This is also clear evidence that issues such as hierarchy, poor communication and some doctors’ resistance to being challenged affect hospital care every day. Such factors are crucial to any explanation as to why Martha lost her life.
For instance, consultants failed to move her to intensive care, even though at least one nurse identified that’s where she needed to be: had Martha’s rule been in place, the nurse could have called the number.
The hospital’s escalation protocol on the day of Martha’s severe deterioration was tightly structured around the opinion of the ward consultant on duty, who was at home, didn’t come into hospital, and got everything catastrophically wrong, as a professional tribunal has judged: all the ward doctors were bound by the hierarchy.
Martha’s rule would have given them more agency and might h
Martha's rule is already having a life-saving impact