Every emergency department in England will adopt Martha’s Rule by March 2028, the government has confirmed — giving patients and families the right to request an urgent clinical review if they believe a patient’s condition is deteriorating and their concerns are not being heard. Gloucestershire Hospitals NHS Trust was the first in the South West to pilot the scheme, running the programme at both Gloucestershire Royal Hospital and Cheltenham General Hospital since January 2026.
What Is Martha’s Rule?
Named after 13-year-old Martha Mills, who died from sepsis at King’s College Hospital in London in 2021 after concerns about her deterioration were not acted upon, Martha’s Rule establishes three core rights for patients in emergency care. Staff must ask patients at least daily how they are feeling and whether they are getting better or worse, and act on that information in a structured way. Any member of staff can at any time request a review from a different clinical team if they believe a patient is deteriorating. And patients, family members and carers in A&E can call a dedicated phone number to trigger a rapid independent review if they are worried a condition is worsening and is not being taken seriously.
Cheltenham Connections: Lives Already Saved
For Elliott Paterson from Cheltenham, the scheme is not an abstraction. He says Martha’s Rule saved his father’s life at Gloucestershire Royal Hospital last year after his dad broke his ribs and was subsequently found to be suffering from a rare autoimmune disease complicating his recovery. Paterson used the scheme to contact GRH’s critical care team directly when he felt his father’s deterioration was not being addressed quickly enough. “To hear Martha’s Rule is now to be rolled out across the NHS is brilliant news and I hope that for more people it will continue to save lives,” he said. “I am incredibly fortunate and grateful to have had Martha’s Rule at our disposal at the time.”
Gloucestershire Hospitals NHS Trust said patient, family and carer voices are “vital in recognising deterioration”. A trust spokesperson confirmed the scheme has been used appropriately for clinical matters eight times since the pilot began in January 2026. “Our commitment is to listen and respond to concerns and Martha’s Rule provides a tool for us to enhance this,” the spokesperson said.
Background: A Campaign Born from Tragedy
Martha Mills died at King’s College Hospital in August 2021 after a cycling accident led to a pancreatic injury. Her parents, Merope Mills and Paul Laity, raised concerns during her treatment that were not acted upon in time. A subsequent inquest found her death was preventable. Her parents campaigned publicly for the rule that now bears her name, and the government committed to a phased rollout across the NHS in England. The West of England pilot — covering Gloucestershire, Somerset and other trusts — began earlier this year, with Health Innovation West of England co-ordinating implementation. Nationally, around 30 per cent of calls made under the scheme have related to acute deterioration and led directly to changes in treatment or enhanced levels of care.
What Happens Next
The government has set a target of full rollout to every A&E department in England by March 2028. Gloucestershire Hospitals NHS Trust is already operating the scheme at both its main emergency departments, placing the county ahead of the national curve. Families in Cheltenham and across Gloucestershire who want to use Martha’s Rule can request information from Cheltenham General Hospital or Gloucestershire Royal Hospital directly. This is a developing story as further NHS trusts confirm their implementation timelines.
