Martha's rule - what is it and what does it mean for patients?

AAT CEO Stevie attended a conference on Martha's Rule, to find out about the right to ask for a second opinion, and what that means for aplastic anaemia patients.

What is Martha's Rule?

Martha's Rule gives a patient (or their family or a member of hospital staff)  the legal right to a second opinion from a different senior medic at the hospital, if the patient's condition is deteriorating rapidly and feel they are not being listened to by the clinical team. 

The rule is named after the tragic preventable death of a little girl called Martha Mills,who developed sepsis after she was admitted to hospital with a pancreatic injury after falling off her bike. 

The rule is currently being implemented in hospitals. It's a new measure, so the NHS has some time to work out how it's going to work in practice, and find out if it meets the aims of improving communication between patients and clinical teams - and thereby patient safety. 

This month I attended a conference to delve deeper into what this means for patients.

How will it work?

We heard at the conference I attended how this is currently being worked out. The first step was for hospitals to sign up voluntarily to implement Martha's Law early and try it out. 

I was really encouraged to hear that 143 hospitals have already signed up to do this. They don't receive any extra funding and, at the moment, it's not a legal requirement. Hospitals are signing up because they care about patient safety and they believe Martha's Law has potential to improve things. There has been a real movement that has built up within the NHS among key people and hospital leaders, who see this as a potential way to improve patient safety. 

Martha's Rule gives people a direct trigger for a clinical review if they're uncertain about what's happening. Ultimately the test will be if this delivers the necessary culture change for patients to be truly listened to, so that it actually doesn’t have to be used.

This implementation is about more than just giving everyone the right to a second opinion. I heard about practical tools and measures being implemented to help identify when a patient is deteriorating. For example the importance of asking every day "How are you feeling today? The same, better or worse?" This also engages and helps to improve that vital communication between patient and clinicians.

Patient power

Martha's Rule is a really inspiring example of how stories can drive policy changes that have a potentially huge impact. Versions of this policy were being considered and discussed already, but Martha Mills' family, their story and their campaigning have really made this happen. 

Privilege

These inequalities can be particularly keen for a rare condition like aplastic anaemia. As our community know very well, someone with a very rare condition like  AA has an additional burden of being their own expert, learning about the condition and repeatedly explaining it to healthcare professionals. 

The skills and expertise of Martha's parents have helped get this issue on the agenda. But when Martha was deteriorating in hospital, we know her parents' concerns were not taken seriously. I was thinking a lot during the conference about how much more difficult this would be for a family facing additional barriers of language or class. We heard about a little boy called Yusef who also died of Sepsis whose parents were both doctors but who felt their concerns had been ignored - and they felt that their race and having English as a second language were factors.

The risk of Sepsis is twice as high if you are not white.

Back to work at The AAT

So much of what we do at The Aplastic Anaemia Trust is about standing in your corner and supporting you in advocating for yourself within the healthcare system. We want everyone affected by AA to know they can contact us for signposting and advice. 

Our support team have been briefed on Martha's Rule, and I also learned at the event about the charity AvMA who do great work supporting patients who have had a poor experience. Of course, we'd hope the need for this among our community would be extremely rare - but it's important for our team to know about where we could signpost people to if they needed this kind of support. 

We are here for you

The patients whose stories I heard at the conference didn't have aplastic anaemia. But it is important for people with AA to understand the signs of Sepsis and to take them seriously. You can find out lots more information about aplastic anaemia and Sepsis here:

We'd encourage any of our community to feel empowered to ask for a second opinion if you feel a need to. If you need our support, or  have concerns or questions about anything mentioned here, get in touch with us via our Support Line:

You can read a bit more about Martha's Rule and see a full list of the hospital sites currently signed up to implement the rule on the Patient Safety Commissioner's website. 

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