What is Martha’s Rule?
Martha’s Rule gives patients, families and staff the right to ask for a rapid clinical review if they are worried that a patients condition is getting worse or not improving as expected.
It is designed to make sure concerns are listened to and acted on quickly.
This guide explains what will happen if you activate Martha’s Rule at Doncaster and Bassetlaw Teaching Hospitals (DBTH).
On this page
- When should Martha’s Rule be used?
- How can you use Martha’s Rule?
- What happens when you raise a concern?
- What could happen after the review?
- Will this be recorded?
- Our commitment to you
- Learn more about Martha’s Rule
When should Martha’s Rule be used?
Martha’s Rule can be used if you:
- Are worried that your loved one, whether they are a child, adult, a relative or friend, is becoming more unwell
- Feel their condition is not improving as expected
- Believe your concerns have not been fully addressed through the usual ward or team discussions.
Martha’s Rule is not used for general complaints (for example, parking, food, or bed allocation). These will still be managed through the Trust’s Patient Advice and Liaison Service (PALS).
How can you use Martha’s Rule?
You can use Martha’s Rule by speaking to ward staff as soon as possible to raise your concerns. If you feel your concerns are not being heard, you can request a rapid clinical review.
If you are still worried after this, you can call 07584 186560 (Doncaster Royal Infirmary and Montagu Hospital) or 07920 081951 (Bassetlaw Hospital).
What happens when you raise a concern?
Step 1. Your concern is taken seriously
A member of the site team will respond. Their role is to provide a “fresh pair of eyes” and review the situation independently.
They will:
- Listen carefully to you and your concerns
- Discuss the patients current condition
- Check recent observations such as heart rate, breathing, oxygen levels have been completed
- Ensure the patient is safe
- Refer to the appropriate clinical team for a rapid review if it meet the criteria for Martha Rule.
You will be treated as an important part of the care team.
Step 2. A clinical review takes place
The reviewing clinician will:
- Carry out or confirm a full assessment (often called an A–E assessment: Airway, Breathing, Circulation, Disability, Exposure)
- Review test results
- Consider whether further investigations are needed (for example blood tests, scans, or monitoring)
- Consider whether treatment needs to change
- Think about different possible causes for your loved one’s condition.
If urgent or emergency treatment is needed, this will happen immediately.
Step 3. You are kept informed
The clinician responding is also acting as your advocate. This means they will:
- Help you explain your concerns.
- Make sure your concerns are clearly communicated.
- Support respectful discussion between you and the care team.
If needed:
- A translation service can be arranged
- Communication support can be provided
- Adjustments can be made for disability, neurodiversity, or cultural needs.
Misunderstandings or communication difficulties are often part of why Martha’s Rule is activated, and aims to address these openly and respectfully.
What could happen after the review?
Following the review, one of the following may happen:
- Reassurance with a clear explanation and plan
- Changes to treatment (for example antibiotics, fluids, oxygen, seizure treatment)
- Increased monitoring
- Transfer to a higher level of care (such as the Department of Critical Care)
- Referral to a specialist team or another hospital if needed
- No change.
You will be told what the outcome is and what the next steps are.
Will this be recorded?
Yes, to improve safety and learning:
- The Trust records that Martha’s Rule was activated
- Anonymous information may be shared regionally and nationally to help improve care
- No identifiable patient information is shared outside the clinical team.
This helps the Trust to understand patterns, improve communication, and prevent future deterioration.
Our commitment to you
When Martha’s Rule is activated, we commit to:
- Listening without judgement
- Acting promptly
- Reviewing the patient thoroughly
- Communicating clearly
- Learning from every escalation.
You should never feel worried about “making a fuss.” If you are concerned, it is always appropriate to speak up.
Learn more about Martha’s Rule
Merope Mills, Martha’s mother, explains Martha’s story here:
You can also find out more about Martha’s Rule on the NHS England website.
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