Ministers in England are considering the introduction of “Martha’s rule” to facilitate easier access to second medical opinions for patients and their families who feel their concerns are not being adequately addressed by medical staff. Health Secretary Steve Barclay has cited a similar measure implemented in Australia, which has been credited with saving lives. Officials are now examining the potential for such initiatives to enhance patient safety in the UK.
This initiative follows a tragic incident involving Martha Mills, a 13-year-old girl who passed away due to sepsis while under the care of King’s College Hospital NHS Foundation Trust in south London. A coroner’s ruling stated that Martha might have survived if doctors had recognized warning signs and transferred her to intensive care earlier. Her parents have been advocating for changes in her memory.
Martha had sustained a pancreatic injury from a bicycle accident during a family holiday in Wales and was receiving care at King’s, known for its specialization in pediatric pancreatic issues. Despite several opportunities to transfer Martha to intensive care, this was not done, leading to an apology from the trust for errors in her care.
Martha’s parents are urging the implementation of Martha’s rule, which would allow patients, families, and care workers to easily request a second opinion from a senior doctor within the same hospital in cases of suspected deterioration or serious concerns.
Steve Barclay mentioned a similar initiative called “Ryan’s rule,” which was introduced in Queensland, Australia, after the death of Ryan Saunders from an undiagnosed streptococcal infection. Ryan’s rule involves a three-step process allowing patients or their families to request a clinical review of their case when their condition is deteriorating or not improving as expected. Barclay highlighted that this approach had saved lives in Queensland and prompted further investigation into its potential in the UK.
Merope Mills, Martha’s mother and an editor at The Guardian, emphasized that if a patient and family escalation system like Martha’s rule had existed and been prominently advertised in the hospital, it might have saved Martha’s life.
An NHS England spokesperson emphasized that patients and families already have the ability to seek second opinions if they have concerns about their care and that it is crucial to respect patients’ wishes in this regard.
King’s College Hospital NHS Foundation Trust expressed deep regret for failing Martha and outlined several clinical improvements made in response to her death, including mandatory sepsis training, a new team dedicated to reviewing seriously unwell children, and formal documentation of parental concerns.
The implementation of Martha’s rule is being explored as a potential means to enhance patient safety and address concerns raised by Martha’s tragic case.