You may have heard about Martha’s Rule, a new initiative that will enable in-patients and their families and carers to obtain a rapid clinical review if their condition is deteriorating in acute and specialist hospitals.
There are three elements to Martha’s Rule, based on the recommendations made by the Patient Safety Commissioner to the Secretary of State for Health and Social Care.
- Patients will be asked, at least on a daily basis, about any worries or concerns about their condition and this information will be used in a structured way to escalate concerns.
- All staff will have access to an escalation route for concerns about deteriorating patients, by contacting a Critical Care Outreach Team who can provide rapid review 24/7.
- This escalation route will also be available to patients themselves and their carers – this is Martha’s Rule.
The experience from providers in England and in other countries which have introduced similar initiatives is that the number of calls made from patients and families is a very small percentage of overall calls to Critical Care Outreach Teams (CCOT).
Freedom to Speak Up guardians have a key role to play in the implementation of Martha’s Rule as part of a speak up, listen up, follow up approach. Guardians can support the workers who speak up using the escalation route as well as the CCOT staff who will be listening up, answering the calls from staff, patients, and families. In terms of follow up, guardians can provide support to these teams to advise the organisation’s leaders in terms of what actions are taken following the use of Martha’s Rule, and how leaders improve listening to workers and patients.
Currently 143 sites have signed up to be part of the NHS England pilot to implement Martha’s Rule.
The new initiative will improve patient safety as part of the NHS Patient Safety Strategy approach to deteriorating patients: PIER (prevention, identification, escalation, and response). It should help to prevent deterioration through patient reported concerns, identify patients who are deteriorating and provide them with a rapid escalation and response, thus reducing the risk of serious harm or even death. It will also help to identify areas for improvement.
You can find out if your organisation is part of the pilot here