Martha’s Rule – the right to a second opinion

Posted: 15/08/2024

‘Martha’s Rule’, which allows patients to seek an urgent second opinion, is being introduced across the NHS. The rule is named after Martha Mills, a 13-year-old girl who sadly died after she developed sepsis in hospital.

Sepsis is life-threatening and difficult to spot. It is caused by the body’s own response to infection, which can develop and spread to the internal organs quickly and cause death if left unaddressed. Timely treatment is therefore of paramount importance when it comes to sepsis.

Martha, who died in 2021, had been admitted to hospital with a pancreatic injury after falling off her bike. Her parents repeatedly raised the alarm about sepsis but, tragically, she died because her symptoms were missed, causing a delay in moving her to intensive care.

Martha’s family campaigned for the new rule, which allows patients and their families to seek an urgent review from a critical care outreach team if their condition deteriorates and they are concerned that they are not being listened to. The rule will be phased in across the NHS, starting with 143 hospitals by March 2025. The process is expected to be expanded across all acute hospitals, subject to government funding.

Martha’s Rule is made up of three parts:

• All hospital staff will have 24-hour access to an urgent review from a critical care outreach team that they can contact if they are worried about a patient.
• All patients, families, carers and advocates will have access to the same team, which they can contact if they have concerns about their care.
• Staff will obtain information on a patient’s condition directly from the patient or their families at least daily.

There are approximately 50,000 deaths each year in the UK relating to sepsis. Sadly, according to recent research from the University of Manchester, people from socioeconomically deprived backgrounds are almost twice as likely to die from sepsis than those from non-deprived backgrounds. The study, published in November 2023, also found that people with learning disabilities were almost four times as likely to develop sepsis than those without. These results make it clear that more needs to be done to protect the most vulnerable people in the UK from developing sepsis, and to treat it appropriately and promptly as soon as it does develop.

The researchers in the University of Manchester study also noted that cancer, neurological disease, immunosuppressive conditions, and having had multiple courses of antibiotics in the past also increased the chances of developing sepsis. They highlighted that there is a need for sepsis risk prediction models, incorporating all these factors, to ensure that vulnerable groups are not disproportionately affected by sepsis.

The study also highlighted the need for education so that members of the public from all backgrounds are aware of the symptoms of sepsis and what to do if they, or their families, have these symptoms. The Sepsis Trust provides such information, and further details on how to spot sepsis can be found here.

More education on the symptoms of sepsis and the importance of treating it promptly is vital both within healthcare and in the general population. With Martha’s Rule being put in place, it is hoped that families feel able to seek a second opinion quickly, so that treatment for sepsis can be commenced swiftly and, hopefully, lives saved.

This article was co-written with Lorraine Smith, senior paralegal.

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