Many of the families who contact us say the same thing at the start of their conversation:
“I knew something wasn’t right, but no one listened.”

Sadly, that experience is far more common than it should be. Patients can deteriorate quickly in hospital, and when early warning signs are missed or concerns are dismissed, the consequences can be devastating. Martha’s Rule has been introduced to help prevent exactly this kind of avoidable harm – by making sure patients, families and staff are listened to when someone’s condition is getting worse. It's not in every hospital yet, but it should be by March 2027.

Trusting your instincts as a patient or parent

When a loved one is unwell, families often notice subtle changes long before medical charts show anything is wrong: increasing pain, unusual behaviour, breathing changes, confusion, exhaustion, or simply that the person ‘isn’t themselves’.

In many clinical negligence cases, families describe repeatedly raising these concerns, only to be reassured, told to wait or left feeling they may be overreacting. In some situations, families are even told it is safe to go home. By the time the seriousness of the situation is recognised, valuable time has been lost.

That was the experience of Harry’s parents, who we represented. Harry was just five years old when he was taken to A&E with clear signs of sepsis. His mother repeatedly told staff that she believed he was getting worse. She was reassured repeatedly and left feeling unheard. Basic sepsis protocols were not followed. By the time treatment began, it was too late. The NHS Trust later admitted that Harry would have survived if appropriate steps had been taken earlier.

What Martha’s Rule is designed to change

Martha’s Rule exists because experiences like this keep happening.

Named after 13‑year‑old Martha Mills, who died after her deterioration in hospital was not acted upon, the rule gives patients and families a clear right to ask for an urgent clinical review if they are worried that someone is getting worse and feel they are not being listened to.

In practical terms, Martha’s Rule means:

• Patients should be asked regularly how they feel and whether they think they are improving or deteriorating.
• Hospital staff – including junior nurses and doctors – can ask for an urgent review if they believe deterioration is being missed.
• Patients, parents and carers can escalate concerns themselves, often via a dedicated number or process displayed on wards.

The Martha's Rule provision has been rolled out to 143 hospitals so far, so it's not in every hospital yet. You can find out if it's in your hospital by checking the hospital's website or asking a member of staff. The website or a member of staff will give you the helpline number to call. 

The difference it can make is simple: avoiding situations where worries are brushed aside and deterioration is recognised too late. The data shows that out of more than 12,000 calls made between September 2024 to February 2026, almost 3,000 resulted in clinical concerns being addressed, such as medication or investigation delays. 

Why this matters in clinical negligence cases

From a legal perspective, failures to spot and respond to deterioration are among the most serious – and preventable – types of medical negligence. We frequently see harm caused by:

• Delays in diagnosing sepsis or infection
• Failure to start treatment promptly
• Delays in escalating to senior clinicians or intensive care
• Not listening to family concerns
• Over‑reliance on reassurance rather than review

We also see many situations where junior doctors, nurses or other less senior clinicians are worried, but the hierarchy of the NHS makes it difficult for them to escalate the patient to senior care. These Martha's Rule helplines are there to help staff too - new figures show more than 1,700 calls have been made by NHS staff to flag concerns about patient care.

Martha’s Rule highlights something patients have always known: you are not ‘just being anxious’ if you think something is wrong. Your voice matters. When a hospital ignores clear signs of deterioration or refuses to review a patient properly, the consequences can be life‑changing, or life‑ending.

If this sounds familiar, you are not alone

Many clients come to us months or even years after an incident, still unsure whether what happened was ‘just one of those things’ or something more serious. Often, they have been told nothing could have been done differently – only to later discover, through independent investigation, that earlier treatment could have changed the outcome.

In Harry’s case, his parents were initially told that his care had been appropriate and that earlier treatment would not have made a difference. It was only after seeking legal advice and pursuing a claim that the truth emerged.

Speaking up – and seeking answers

Martha’s Rule is an important step forward, but it does not erase past harm, and it will not always be used when it should be. Patients and families will sadly continue to suffer when concerns are ignored.

If you believe that you or your loved one deteriorated in hospital, your concerns were not listened to and this caused harm, you are entitled to ask questions of the NHS and to seek independent legal advice. If your instincts told you something wasn’t right, it is worth listening to that voice now. For further information or advice on this matter, please get in touch.