Medical Negligence

Martha’s Rule to be implemented in hospitals in major step for sepsis diagnosis and patient safety


Matthew Gascoyne

Team Leader & Senior Associate Solicitor

5 min read time

One of the largest causes of death and serious injury across the country is the subject of a new initiative being rolled out across 100 NHS hospitals in England which aims to empower patients and families to seek urgent reviews and second opinions.

Sepsis is a major cause of hospital admissions, with almost 250,000 cases diagnosed each year within the NHS. It is a serious and frequently life-threatening condition and is caused by an abnormal reaction of the body’s immune system to infection.

Sepsis can develop following an injury, surgery or as a result of common infections such as urinary tract or respiratory infections.

The rate of death following the development of sepsis has been reported as high as 30 per cent and it is estimated it is the cause of death for around 48,000 people within the UK each year.

Even where death is avoided, serious and life-changing injuries can occur due to the tissue damage and organ failure, with an estimated 78,000 people per year experiencing physical, psychological and/or cognitive problems says The UK Sepsis Trust.

Despite this, the diagnosis of sepsis is too often not made or is delayed, leading to concern that many cases of death or serious injury could have been avoided.

If you or a member of your family has suffered as a result of a late diagnosis of sepsis and want to speak to us, contact our medical negligence experts today.

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The experience of Martha Mills, whose parents have campaigned for this initiative, demonstrates the risks. Martha, who was 13, suffered pancreatic trauma following a fall from her bike. She was admitted to the hospital where her condition deteriorated as a result of sepsis. Her parents raised concerns about this deterioration and asked for her to be transferred to the Intensive Care Unit. Unfortunately, they felt that the concerns they raised were ignored and no transfer took place.

Sadly, Martha passed away as a result of her sepsis. Her death, which could have been avoided with the proper escalation in care, prompted her parents to launch their national campaign.

This campaign sought to build on a pilot scheme launched by NHS England, which was rolled out to seven NHS Trusts in 2023. This provided information and a pathway for patients and their families to raise concerns about symptoms, seek a second opinion from a specialist in recognising sepsis and escalate the care where this was confirmed.

As a result, NHS England has extended and expanded the scheme, which rolls out across 100 hospitals in England from April 2024. ‘Martha’s Rule’ requires hospital staff to make a formal record of insights and information about a patient’s condition, provided by the patient and/or their parents, on a daily basis.

The rule also allows patients and their families to seek additional medical opinions where they feel that concerns they have raised are not adequately dealt with.

The hospital trusts are to be given additional resources to ensure that the second opinion is available 24 hours a day, seven days a week. While the right to a second opinion is available in all situations, it is specifically hoped that these measures will ensure that deterioration or changes in behaviour and wellbeing are recognised earlier, leading to quicker identification of cases of sepsis.

While initially limited to 100 hospitals, it is planned to review the rollout by 2025 and further expand the scheme across more hospitals, other healthcare providers and within community services.


Matthew Gascoyne, Associate Solicitor and Team Leader in the clinical negligence department, says:

It is too often the case that possible symptoms of sepsis are not investigated and that families’ concerns are not taken seriously. Avoidable harm and death as a result of sepsis are too common and steps need to be taken to ensure timely recognition and treatment.

‘Martha’s Rule’ is an extremely important tool, recognising that patients and their families are often best placed to recognise deterioration in their condition and reflecting the need for their concerns to be properly acted on. Early treatment of sepsis is vital to giving the best chance of recovery and this promotes patient safety.

It is important that hospitals are resourced properly to make the scheme effective and that patients and their families are properly informed of the signs to look out for as well as the availability of the second opinion.

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Sepsis Negligence

As specialists who regularly deal with sepsis claims, we know how important a compensation settlement can also be to help support people through vital rehabilitation treatment.

If a delay has been caused by a medical professional failing to spot the signs correctly, or they didn’t react with the required urgency, you may be able to make a sepsis compensation claim.

Read more: Sepsis Negligence Compensation Claims

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Martha’s Rule to be implemented in hospitals in major step for sepsis diagnosis and patient safety

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