In June 2024, “Martha’s Rule” was introduced into 143 NHS Trusts. This rule allows patients, families and staff to quickly request an urgent review from an independent medical team if they’re worried a patient is worsening and feel their concerns aren’t being heard. It also requires hospitals to regularly check in with patients and families about how the patient is doing. An independent evaluation was carried out between November 2024 and February 2026 by the by the patient safety arm of the NIHR Policy Research Unit in Quality, Safety and Outcomes for Health and Social Care to understand how the first rollout of Martha’s Rule is working for patients, families and healthcare staff.
This interim report presents findings from this evaluation addressing a number of research questions about the factors that contribute to successful implementation of this policy and also some of the challenges experienced in the first phase of its rollout. It draws on a prospective in depth case study across three hospital trust pilot sites, involving observations, interviews and documentary analysis, accompanied by a systematic review of literature and a public awareness survey, which was conducted in collaboration with Picker.
The interim report highlights key findings and implications for policy makers, further rollout and onward research. These findings have already been used to inform national guidance, including the development of the Martha’s Rule core standards. The final report of this evaluation is expected to be published in the Summer.
For any questions or comments, please email marthasrule.study@bthft.nhs.uk
