Martha’s Rule: In practice

June 25, 2025

When speaking to new clients, we often hear the same thing: “We knew something wasn’t right, but no one listened.”

That’s why we’re so glad to see a new NHS rule – known as Martha’s Rule – starting to show up in the hospital records we look at for our clients. It’s a prompt that asks doctors and nurses to check in with families every day and record how they think the patient is doing:

“Ask the patient/family at least daily how THEY THINK their clinical condition is.”

It’s a small change. But it could prevent serious harm and save lives.

What Is Martha’s Rule?

Martha’s Rule was introduced following the death of 13-year-old Martha Mills, who died from sepsis in 2021 after her parents’ repeated concerns were ignored.

We acted for Martha’s parents and her case highlighted a common issue in healthcare: families know something is wrong, but they can’t always get senior doctors to listen.

Martha’s Rule allows patients and families to request a second opinion from a different medical team when they believe a condition is getting worse – even if the current team disagrees.

The NHS is rolling this out across over 100 Trusts, with plans for wider implementation by 2026.

You can read more about the background in our earlier article: Martha’s Rule: A Game – Changer for Patient Safety.

Why this matters for patients and families

In medical negligence cases, a recurring theme is this: patients or relatives spoke up, but no one acted. Martha’s Rule gives those voices more weight – and a place in the medical record.

When a family’s concerns are formally noted, it’s harder for healthcare providers to overlook them. If something goes wrong later, that record can play a crucial role in a medical negligence claim – but hopefully it won’t come to that.

How Martha’s Rule supports a legal case

If you raised concerns that weren’t followed up and harm occurred, having a note of your warnings in the records strengthens your case. Martha’s Rule doesn’t just protect patients – it could also help establish a clear duty of care in legal claims.

What to do if you’re worried about hospital care

If someone close to you is in hospital and you’re worried about their condition, you have a right to speak up.

Under Martha’s Rule, you can ask for a second clinical opinion – and the hospital must take that request seriously.

If, after doing so, you’re still concerned about the level of care being received, these are the steps you can take to progress it further:

Contact the PALS Team (Patient Advice and Liaison Service)

If you’re not satisfied after speaking to ward staff – or you don’t feel able to – you can contact the hospital’s PALS team.

PALS exists to:

Help patients and families navigate NHS services.
Listen to concerns and resolve them informally.
Explain hospital policies and procedures.

They can often mediate between you and the hospital team, helping to find a resolution without making a formal complaint.

You can usually find the PALS office near the hospital’s main reception or by checking the hospital website.

Make a Formal Complaint to the Hospital

If informal efforts don’t help, or the issue is serious, the next step is to make a formal complaint.

Put your complaint in writing – an email or letter is best.
Address it to the Complaints Manager or Chief Executive of the NHS Trust.
Clearly outline:
- What happened
- Why you’re unhappy
- What you’d like to happen next (e.g. an explanation, apology, policy change)

Try to keep your tone calm and factual, even if you’re upset. This will help your complaint be taken seriously and responded to more quickly.

You normally need to make a complaint within 12 months of the incident, though this can be extended in some circumstances.

Escalate to the Parliamentary and Health Service Ombudsman

If you’re unhappy with the hospital’s formal response – or if you feel the complaint wasn’t handled fairly – you can escalate the issue to the Parliamentary and Health Service Ombudsman (PHSO).

The PHSO is independent of the NHS and can investigate complaints about:

Poor treatment or service
Unfair handling of a complaint by the hospital

Before contacting the PHSO, you’ll need to show that you’ve completed the hospital’s own complaints process. You can find more about how to make a referral at ombudsman.org.uk.

Contact Davies and Partners

At Davies & Partners, we specialise in helping families who’ve experienced NHS negligence.

We’ll listen, review what happened, and advise you clearly on whether you have a claim.