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Meningitis Now welcomes the introduction of Martha’s Rule

9th March 2024

Last week it was announced that “Martha’s Rule” would be introduced to a selection of English hospitals from April 2024. Our Chief Executive, Tom Nutt, reacts to the news.

martha's rule

Martha’s Rule will allow patients whose health is deteriorating to have a second opinion about their care. This review of their condition will involve doctors and nurses who weren’t previously involved in the medical team treating them.

This is an important step that we at Meningitis Now fully support and understand the need for.

The rule is named after Martha Mills, a thirteen-year old who died from sepsis in 2021 after her parents’ concerns were dismissed by clinicians. An inquest found that Martha probably would have survived if she had been moved to intensive care sooner. Since her daughter’s death, journalist Merope Mills has been campaigning tirelessly for the right for patients to have a second opinion.

At Meningitis Now, we have seen too many tragic cases like this.  Three such cases were documented in an official report presented to the then Secretary of State for Health and Care, Jeremy Hunt, in 2018, entitled the ‘Meningococcal Working Group Report’. This called for:

  • clinicians to “listen to parents, carers and family members” because “parents know their child best”
  • clinicians to record parental views in the patient’s notes, where that was not already done.
  • clinicians and health leaders to “reflect on how best to promote a culture where staff feel empowered to challenge colleagues across different levels of seniority and where staff are also open and responsive to challenge and to learning from mistakes and near misses whether via training or other means”.

This illustrates how the issues underlying Martha’s case are sadly not new. The fact this report was published over five years ago shows how difficult and slow changing culture and practice can be. You can read the report on the website of the Department of Health and Social Care here.

Since then, NHS England has been working on a series of pilot projects across English hospitals to understand how listening to the worry and concern of patients and their carers can become a systematic part of the diagnosis and treatment of people experiencing acute deterioration. Additionally, these projects aim to highlight how patients and carers can be empowered to speak up when their concerns are not heard. Meningitis Now has been sitting on the Steering Group for these pilots, which are known as the ‘Worry and Concern Collaborative’. Other similar initiatives are taking place in Wales.

Currently, Martha’s Rule is set to be adopted in 100 English hospitals from April. The changes will be evaluated by the NHS and hopefully rolled out to more hospitals and other health settings across the UK.

Supporters of Meningitis Now will know that there have been too many cases of meningitis where clinicians overlooking the concerns of loved ones has ended in tragedy. We hope the introduction of this important rule will serve as a reminder for people to trust their instincts when a loved one is unwell – it could save their life.