Call 4 Concern (Martha's Rule)

Martha's Rule: Detecting Deterioration

You know yourself or your loved one better than anyone. If you’re worried about a health condition getting worse, talk to us.

What is Martha's Rule?

We have introduced Martha’s Rule to help spot any unexpected signs of deterioration early and give you the right to request a rapid review if you’re worried that your or your loved one’s condition is getting worse.

You may notice small changes before they show up in our routine measurements. These changes could be early warning signs of deterioration.How we monitor patientsWhile someone is in hospital, we regularly check their vital signs and other important health measurements. The frequency of these checks will depend on the patient’s individual condition and needs. Sometimes we may need to wake patients to do these checks

In addition, we will also ask at least daily if patients are feeling better or worse. This is to monitor any unexpected changes in their condition. What to do if you're worried 1. First, speak to the team caring for you or your loved one 2. If, after speaking to the care team, you remain worried and feel your concerns are not being addressed, call for a rapid review.

Phone: 0151 604 7676 or ext 7676.

Your call will go to a different team in our hospital, who specialise in the care of critically ill patients. They will work with your or your loved one's care team to arrange any treatment needed or further review.

The service is available 24 hours a day, seven days a week.

Our commitment

We will regularly ask for your views and take your concerns seriously. We see you as a partner in the care we are providing and want you to raise any worries and concerns you may have.

Difference between Martha’s Rule and second opinion

Martha’s Rule allows hospital inpatients and their families to seek a rapid review if 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.

Martha Mills

Martha Mills died in 2021 after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling off her bike. Martha’s family’s concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that Martha, aged 13, would probably have survived had she been moved to intensive care earlier.

Patient Information Leaflet

There are two leaflets available. One is for adult patients and one for children. Please see the document links below.

The information contained within the patient information leaflet is available in several languages and in the following accessible formats: easy read, word document and British Sign Language.

Please visit: NHS England » Martha’s Rule information for patients, families and carers