Mom hopes Martha’s rule will ‘topple’ hospital ward hierarchy

The mother of a 13-year-old girl who died of sepsis has said she hopes Martha’s rule, which gives patients and their families the right to a second medical opinion, will “topple” the “hierarchy” in hospital wards.

Merope Mills, who campaigned with her husband, Paul Laity, to give families more control over care after the death of their daughter Martha, also called for “mutual respect” between patients and doctors.

More than 140 NHS sites in England have agreed to implement Martha’s Rule, a patient safety initiative that gives patients and their families 24-hour access to a rapid assessment by an independent intensive care team from elsewhere in the hospital if they feel that their health, or that of a family member, is deteriorating and they are not being listened to.

Martha died of sepsis in 2021 after suffering a pancreatic injury when she fell from her bicycle. Mills and Layman expressed concerns about their daughter’s health a number of times, but these were brushed aside.

A coroner ruled that the teenager most likely would have survived if doctors had noticed the warning signs of her rapidly deteriorating condition and transferred her to intensive care earlier.

Speaking at the NHS ConfedExpo on Wednesday, Mills, editor-in-chief at The Guardian, said: “My big thing is I think we need to be more equal.

“It’s a very unequal place, a hospital ward, and there is a hierarchy, which is very steep and very strict. And you know, when I first started talking about that, I thought nurses were at the bottom of the hierarchy.

“And I refer to that because in Martha’s case they didn’t feel the ability to say anything. But I’ve actually come to realize that the people at the bottom of the hierarchy are the patients.

“They are the ones with the least power and I would like to improve that and just have a sense of mutual respect between doctor and patient.”

In February it was announced that Martha’s rule was expected to be rolled out to at least 100 NHS trusts in England from April. Last month, NHS England announced that 143 hospital sites would implement the rule, which would be available 24/7 and advertised on posters and leaflets in hospitals.

Aidan Fowler, the national director for patient safety at NHS England, thanked NHS Trusts for the “great response” to the initiative. “We were aiming for 100 because it felt like a really good start,” he said. “When we signed up ten people within the first hour, I knew we were going to exceed that. “And we’ve had 143 locations and there are still people stepping forward. So that’s a great response. So there is enthusiasm.”

Fowler said a pilot model is being developed with the teams that signed up. “There are some basic principles that we know and have been talked about, but there is a huge amount of detail that we are working on together.

“So it shows concern about adult intensive care teams going to see children, and what can we do better in the pediatric area. How we introduce this in the maternity ward has already been mentioned, or in the emergency department.

“Our goal is not to impose a model on the system, but to develop a model that makes sense for the system.

“We’ll do it all once we have a model that we think works. And as soon as we can develop the ideal model, we will do so.”