NMC issue Martha’s Rule escalation warning for nurses

Under Martha’s Rule, patients and staff will have 24/7 access to a rapid review from a critical care team.

Martha Mills suffered a serious pancreatic injury after falling off her bike. Although her parents repeatedly expressed concerns about Martha’s deteriorating health, these concerns were not listened to or acted upon in a timely manner. At the inquest into Martha’s death in 2022 a coroner ruled that Martha would probably have survived had she been moved to intensive care sooner.

Executive Nurse Director at the NMC, Sam Foster, wrote:

“ Working with the Patient Safety Commissioner and leaders across the NHS in England, including nurses, they helped to develop a patient safety initiative in which people who use services, families and carers can get a timely second opinion when they have concerns about deteriorating health.”

Local Processes to Escalate Concerns 

The NHS must implement a structured approach to obtain information relating to a patient’s condition directly from patients and their families at least daily. In the first instance, this will cover all inpatients in acute and specialist trusts.

The NMC continued:

“As nurses, midwives, and nursing associates, the Code sets our professional standards to uphold in our day-to-day practice. Martha’s Rule applies to both children and adults. We encourage you to ensure that you are familiar with your local processes that enable you to escalate concerns relating to patient safety to ensure that Martha’s Rule is embedded in practice.

“As we emphasised in our joint statement with the General Medical Council and Care Quality Commission, we welcome the way that Martha’s Rule emphasises effective teamwork, mutual respect, and open communication.”

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