Martha's Rule elearning

Martha's Rule is a patient safety initiative to support early detection of deterioration by ensuring the concerns of patients, families, carers and staff are listened to and acted upon.
It was developed in response to the death of Martha Mills and other cases related to the management of deterioration by the Patient Safety Collaborative with Health Innovation West of England and NHS England. Central to Martha's Rule is the right to request a rapid review if worried that a patient's condition is worsening and concerns are not being responded to.

About this training
This programme is for all healthcare staff, especially those in managerial roles including nurses, clinicians, allied health professionals and support staff.
By the end, participants will be able to:
- Describe what Martha's Rule is and why it matters for patient safety
- Recognise how patients, families and carers can identify early signs of deterioration and raise concerns
- Explain how collaborative decision-making improves care
- Understand responsibilities in listening, responding and escalating concerns

The training explains Martha's Rule's origins and outlines its three core components:

1. Asking Patients: Patients are asked daily how they are feeling, and this information is acted upon in a structured way.
2. Staff Review: Any staff member can request a review from a different team if concerned about deterioration.
3. Patient and Family Escalation Route: A clear, advertised escalation route available at any time.

The session includes real-life case studies and practical scenarios, and addresses barriers to escalation and the importance of equitable access for all.

Why Martha's Rule matters:

- Empowers patients and families to raise concerns
- Provides reassurance that voices will be heard
- Supports staff in advocating for patients
- Data shows it is saving lives by enabling earlier intervention

Martha's Rule is an urgent process for escalating concerns about acute deterioration, distinct from seeking a second opinion.