One of the most crucial things about effective medical treatment is speed. The faster diagnoses are reached, treatment is given and any signs of getting worse are spotted, the greater the chance of a recovery.
Recent changes in the NHS show that they are taking this more seriously than ever before, with two new initiatives being created to help safeguard patients.
The first is Martha’s Rule, which is now being used by more people than ever before, including calls to the helplines from NHS staff.
Secondly, NHS England has brought in new maternity safety standards to help cut the number of mothers who die during pregnancy or soon after birth.
Building in more checks and safeguards
When something goes badly wrong, reports often say the same things:
- Staff do not always spot early signs that a patient is getting worse
- Worries from patients or their families are not always taken seriously or dealt with fast enough
- Concerns are not always passed up to senior staff when they should be
The new maternity standards focus mainly on the first point: spotting problems earlier, and making sure staff respond in the same clear way.
Martha’s Rule focuses on the other two points. It gives people a clear way to speak up if they feel they are not being listened to.
We explain how it works in our guide to Martha’s Rule and how to raise concerns in hospital.
NHS staff are using Martha’s Rule too
One of the main issues with the NHS care is their organisational complexity, and, as part of that, the bureaucracy it creates.
Martha’s Rule gives NHS staff the chance to bypass that system, and call attention to potential problems with care without needing to send that information through a chain of people.
What we know about Martha’s Rule
We know first-hand about the issues that delays in diagnosis can create, and how that led to the creation of Martha’s Rule, because our team acted for the family of Martha Mills, the young girl whose name is given to the rule. Their experience showed how hard it can be to make sure a very unwell patient is listened to, and helped, in time.
We have written about this case before, and why it is vital to listen when families say something does not feel right.
Before Martha’s Rule, cases like this showed the need for:
- A simple way to raise a concern
- A fast second opinion
- A system that responds quickly when something feels wrong
Martha’s Rule was created to help fix these problems, which had existed long before her case.
Stopping harm vs speaking up fast
Put together, these changes do two things to improve safety:
- The maternity standards aim to prevent harm with clear steps and early action
- Martha’s Rule is there for times when the usual system is not working
They can work in conjunction with each other, providing more opportunities to course correct, and ensure better outcomes for patients.
What this means for you
For patients and families, there is now a recognised route to ask for a second opinion. If you are worried about care, it can make a real difference to know that you can raise a concern and ask for it to be escalated.
For clinicians, it adds an extra formal route to escalate concerns, making it easier for hospitals and NHS trusts to see when concerns are raised and how quickly they are dealt with.
What this could mean for legal claims
This also matters in medical negligence claims.
On a basic level, we hope to see less cases involving delays in diagnosis and treatment, especially for pregnancy care and birth claims. For those cases where something still goes wrong, we may see more:
- Clear records that someone raised a concern
- Checks on how fast staff responded
- Focus on chances to act that were missed
These issues are often at the centre of serious cases where treatment was delayed or a worsening patient was not responded to.
Is it the beginning of a cultural change?
Policies like Martha’s Rule do not create problems, but by making them easier to see it can sometimes make them unpopular in large, target-driven organisations where they would otherwise have gone unreported. In the past, bringing a medical negligence claim has been seen by families as the only way to get NHS trusts to take problems with care seriously.
The fact that Martha’s Rule is being used a lot, including by staff, tells us the current system does not always respond quickly enough.
It also shows that setting standards is not enough on its own. They must be followed to have an effect on patient safety.
Is the NHS safer as a result of these policies?
Patient safety is not only about medical skill, it is about empowering patients, families and staff to make sure that worries are listened to, and acted on fast.
These changes suggest the NHS is trying to do both, and that is where real improvement is most likely.
If you are worried about hospital care
If you are worried about your care, or a family member’s care, it is important to speak up early.
Our medical negligence team often advises on cases where there has been:
- A failure to spot that a patient was getting worse
- A delayed diagnosis or delayed treatment
- Concerns that were raised but not passed on properly
You can contact us for confidential advice, with no obligation.