Martha’s Rule was introduced in NHS hospitals to strengthen escalation when patients, families or staff are worried that a person is deteriorating and their concerns are not being adequately addressed.
The principle is simple: people should have a clear route to request an urgent clinical review rather than relying only on the existing chain of communication. For staff, that can provide an additional mechanism when they believe a patient needs reassessment.
Early call-volume figures can show whether a service is being used, but they should not be treated as proof by themselves that the scheme has prevented a particular number of adverse outcomes. Evaluation needs to examine what concerns were raised, what reviews followed and whether care changed.
Martha’s Rule is part of a broader patient-safety approach that emphasises listening to families and frontline staff, recognising deterioration promptly and creating escalation routes that are psychologically and organisationally safe to use.
