Martha’s Rule has now been officially rolled out across the hospital sites under the North Cumbria Integrated Care NHS Foundation Trust (NCIC).
To reinforce its commitment to patient safety, transparency, and compassionate care, patients and families who are concerned that they are deteriorating in hospital will now be able to request a review from the critical care team.
In 2021, Martha Mills passed away after developing sepsis in hospital. Although her family voiced their concerns about Martha’s deteriorating conditions, these were ignored by staff on site, and in 2023 a coroner ruled that Martha (only 13 years old) would have probably survived had she been moved to intensive care earlier.
Since the start of the year, Martha’s Rule (known as Call for Concern) has been in place across the hospitals – where posters can be found, directing people to call Cumberland Infirmary on 07769 248 453 or West Cumberland Hospital on 07827 983 964, if they feel that their own health or a loved one’s condition is deteriorating. The call will be answered by the critical care team who will arrange an urgent review.
Consultant Anaesthetist at NCIC, Jon Sturman, has said: “Call for Concern gives a voice to patients and their loved ones, we know families know their loved ones better than anyone, they can spot when something isn’t right in ways that even experienced doctors might miss. It’s ultimately another method of escalation, where concerns are highlighted and responded to, which can only make the care we provide safer for everyone.”
As part of the call for concern, teams have also introduced a ‘Patient Wellness questionnaire’ which is a tool designed to spark meaningful conversations about how patients feel their treatment is going – whether they feel they’re improving, and if they have any concerns.
The questionnaire stays with the patient from the point of admission and each day a health care professional will ask the questions to determine if the patient is feeling they are improving. If a patient, family member, loved one or any other member of staff feel a patient is deteriorating and feel the patient would benefit from a clinical review, they can call the Critical Care Outreach team who will action the call.
Lindsay Twentyman, Critical Care Outreach nurse at NCIC said: “On a busy ward, it’s easy for subtle changes in a patient’s condition to be missed. These questionnaires give us a structured way to check in, listen, and act. We also know that family and friends know their loved ones best and can spot signs of deterioration quickly, giving them access to another way to escalate concerns has been received really well.”
Before becoming accessible to all, Call for Concern was initially piloted on four wards across the Cumberland Infirmary and West Cumberland Hospital – where the rollout has been met with enthusiasm from staff across departments.
Teams are already reporting that the wellness questionnaires are helping improve communication and identify issues earlier, with the Ward Manager on the Coronary Care Unit, Estelle Hodges, commenting: “We were one of the initial pilot wards and have had some really positive feedback to the wellness questionnaires, patients are clearer about their management plan, which is designed to get them well and back in their own homes. They are a couple of really simple questions, but they often spark a bigger conversation.”
Call for concern is now in operation for any serious concerns patients or families may have, in the first instance patients and families should speak to the nurse or doctor in charge of their care, for other non-urgent or clinical issues the PALS team are on hand to support.
