Infection control
Martha’s Rule at CDDFT
We have implemented Martha’s Rule to help spot when a patient is getting worse, giving staff, patients, families, and carers a bigger role in their care.
We recognise that patients and the people closest to them are experts in their own health and may notice subtle changes before the health care team. Therefore your input is vital in the care we provide.
Martha’s story
Martha Mills was 13 when she died in 2021 from sepsis that she developed while being treated in hospital for a pancreatic injury following an accident on her bike.
Martha’s families concerns about her deteriorating condition were not responded to. A coroner declared in 2023 that Martha most likely would have survived if she had been admitted to intensive care sooner.
NHS England have introduced Martha’s Rule as a standardised approach that prioritises patient safety and involves the patient and/or their family members when looking at the patients current condition, most importantly giving them a voice to express serious concerns/significant changes.
Whilst in hospital patients will have regular observations which includes monitoring of:
Patients will also be asked the following questions using a patient wellness questionnaire:
This aims to identify subtle changes in a person’s health before usual routes of monitoring.
This diagram has been designed to help you describe what is making you feel worried or concerned.
If you notice any of these symptoms, alert the healthcare team. They could be a sign the patient is getting worse.
What to do if you are concerned the patient is getting worse
Step 1
Speak to the bedside nurse and explain your concerns:
- The nurse will assess the patient’s observations
- The nurse will escalate concerns to the nurse in charge or doctor
- Ask the nurse to keep you informed and involved in any decisions made
Step 2
If your concerns aren't answered:
- Speak to the doctor or nurse in charge
Step 3
If you feel the patient is getting worse after you have raised these concerns with the ward and feel your still not being listened to.
- Call the Call for Concern Service
Call for Concern
Are you concerned about a patient’s condition or feel the patient is getting worse?
If you notice changes which could suggest a health condition is getting worse, please tell any of the staff looking after you or your loved one. If, after speaking to the care team, you remain worried and feel your concerns are not being addressed, call for a rapid review.
- Bishop Auckland Hospital: 01388 455640
- Darlington Memorial Hospital: 01325 743743
- University Hospital of North Durham: 0191 3332700
- Community Hospitals: 0300 1246028
Call for Concern
The Trust’s Acute Intervention Team is committed to supporting all in-patient areas across the trust - in caring for very unwell patients of all ages. Highly visible in purple scrubs the team are experts in caring for the deteriorating patient and form part of the emergency response team for the hospital.
When you use Call for Concern, the Acute Intervention Team will ask you for some details including your name, the patient’s name (if different), the ward name/number, and a brief description of the concern. The Acute Intervention Team Practitioner will prioritise the urgency of the concern and will provide a rapid review of the patient if necessary.
There may be times when the Acute Intervention Team Practitioner cannot answer your call immediately, as the team responds to all emergency calls in the hospitals, and at times may already be assessing a patient. Please leave a message on the voicemail and someone in the team will get back to you as soon as able.
When to contact Call for Concern
- The patient is getting worse or there has been a sudden change in their condition and you have discussed your concerns with the team who is looking after the patient and you feel like you are not been listened to
Difference between Martha’s Rule and a second opinion
Martha’s Rule allows patients, families carers and staff access to a rapid review if they feel that their condition, or the condition of a loved one, is deteriorating. A second opinion is when you would like to see another consultant to discuss any diagnosis or treatment's.
Making a complaint about something else
Please do not make a Call for Concern if you wish to discuss concerns or complaints with any of the following:
- Parking
- Visiting times
- Hospital food or hospital cleanliness
- Complaints
- Any other general issues
These queries can be discussed with the care team looking after the patient or Trust’s Patient Experience Team on: 0800 7835774 or email: cdda-tr.
