Martha’s Law: What Does It Mean for Medical Negligence Claims?

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Martha’s Rule, sometimes referred to as “Martha’s Law”, is changing the way patients and their families can raise concerns about deteriorating patients in NHS hospitals.

But what does it mean if you believe that you or a loved one has suffered as a result of medical negligence?

In this article, we explain what Martha’s Rule means, how it works and whether it could be relevant to a clinical negligence claim.

What is Martha’s Rule?

Martha’s Rule is an NHS patient safety initiative designed to ensure that concerns raised by patients, families, carers and healthcare staff about a deteriorating patient are listened to and acted upon.

It was introduced following the death of 13-year-old Martha Mills. Her family raised concerns about her deteriorating condition while she was in hospital, but those concerns were not acted upon. A coroner later concluded that Martha would probably have survived had she been transferred to intensive care earlier.

Martha’s Rule provides a formal route for concerns about a patient’s deterioration to be escalated.

The initiative has three main elements:

• Patients should be regularly asked how they are feeling and whether they believe their condition is improving or worsening.
• Healthcare staff can escalate concerns about a deteriorating patient.
• Patients and families can request a rapid review by an appropriately skilled clinician if they remain concerned.

NHS England requires NHS trusts and foundation trusts in England to implement the three components of Martha’s Rule by 31 March 2027.

Does Martha’s Rule create a new medical negligence claim?

No.

Martha’s Rule is a patient safety initiative, rather than a new legal cause of action.

For a successful medical negligence claim, it will generally be necessary to establish that:

1. A healthcare provider owed the patient a duty of care;
2. The standard of care fell below what was reasonably expected; and
3. The breach caused the injury or loss suffered.

However, the circumstances surrounding Martha’s Rule could be relevant evidence when investigating a potential clinical negligence claim.

For example, if a patient’s family repeatedly raised concerns about deterioration and those concerns were not appropriately acted upon, it may be important to establish what was reported, when it was reported and what the medical team did in response.

Can Martha’s Rule help prove medical negligence?

Potentially, but it will depend on the circumstances of the individual case.

A medical negligence solicitor may investigate questions such as:

• What concerns were raised by the patient or their family?
• Were those concerns recorded in the medical records?
• Should the patient’s deterioration have been recognised earlier?
• Was Martha’s Rule available at the relevant hospital?
• Was an escalation request made?
• What happened following the request?
• Would earlier treatment have prevented or reduced the patient’s injury?

Importantly, a failure to follow Martha’s Rule does not automatically mean that medical negligence occurred.

Equally, the fact that a patient or family member identified deterioration before clinical staff did may form an important part of the evidence in some claims.

Martha’s Rule and delayed diagnosis

Martha’s Rule may be particularly relevant where there has been a delayed diagnosis or delayed treatment.

Conditions such as sepsis, serious infections, internal bleeding and post-operative complications can deteriorate quickly. If warning signs are present but are not recognised or acted upon, the consequences can sometimes be serious.

In a delayed diagnosis medical negligence claim, the key issue is generally whether the healthcare provider should have identified the condition earlier and whether earlier diagnosis or treatment would probably have resulted in a better outcome.

What evidence could be important?

If you believe concerns about your condition or a loved one’s condition were ignored, relevant evidence could include:

• Hospital and GP medical records
• Nursing and doctors’ notes
• Observation and early warning score records
• Test and scan results
• Medication records
• Records of concerns raised by relatives
• Martha’s Rule escalation records
• Hospital complaints or investigation reports

Obtaining the complete medical records can therefore be an important step when investigating a potential NHS medical negligence claim.

Can I claim compensation?

Martha’s Rule itself does not provide a right to compensation.

A medical negligence compensation claim will depend on whether the legal requirements for clinical negligence can be established, including breach of duty and causation.

If you believe you or a loved one suffered avoidable harm because concerns about a deteriorating condition were not properly addressed, it may be worth seeking specialist legal advice.

Our medical negligence solicitors can investigate your circumstances, obtain relevant medical records and, where appropriate, seek independent medical expert evidence.

If you believe you may have a medical negligence claim, clinical negligence claim or NHS negligence claim, contact Step Legal today on 0800 195 6412 for a free, no-strings attached consultation.