Extension of Martha's Rule to All Maternity Settings
A policy ensuring patients the right to an urgent rapid review of their care is set to be implemented across all maternity units in England. This decision follows a recent review of maternity services at Nottingham University Hospitals NHS Trust, which identified multiple missed opportunities to prevent harm.
Under Martha's Rule, parents can request a rapid review conducted by an independent medical team if they are concerned that the condition of a baby or mother is deteriorating and that their concerns are not being adequately addressed.
Previously, the policy had been introduced for inpatients at every acute hospital in England and piloted in 15 maternity and neonatal settings. The forthcoming nationwide rollout will extend this important safety measure to all maternity units.
Background: The Case of Martha Mills
The scheme was established following the tragic death of 13-year-old Martha Mills, who developed sepsis while receiving care at King's College Hospital NHS Foundation Trust in south London in 2021. A coroner's inquest concluded that Martha would have survived had medical staff identified the warning signs of her condition earlier and transferred her to intensive care in a timely manner.
Findings from Nottingham Maternity Services Review
A comprehensive review of maternity services at Nottingham University Hospitals (NUH) NHS Trust, led by senior midwife Donna Ockenden, revealed that leadership at the trust was aware of serious issues within the maternity department spanning several years but failed to take effective action to prevent further deaths.
Key findings from the review included consistent failure to listen to women and families, which resulted in missed opportunities to prevent harm. Additionally, there were significant shortcomings in recognising and escalating the deterioration of health in both babies and mothers.
Donna Ockenden was appointed in 2022 to lead the Nottingham inquiry.
Government Response and Additional Measures
Health Secretary James Murray stated that extending Martha's Rule is part of a broader initiative to improve safety for mothers and babies, responding directly to the issues highlighted in Ockenden's report.
Additional measures announced include compelling current and former NHS staff who refuse to cooperate with forthcoming maternity reviews to provide evidence, with non-compliance potentially resulting in up to two years imprisonment.
Furthermore, stricter inspections and protocols will be introduced for mortuaries to ensure that the remains of children are treated with dignity and respect.
"Donna Ockenden's review lays bare a culture where too many voices went unheard, too many opportunities to prevent harm were missed and too many lives were lost. That's why we have to take action, and quickly.
No family should ever have to battle the system that is meant to care and protect them - that is why Martha's Rule is so fundamental.
It provides a way for a concerned mum or family member to raise the alarm before it is too late.
I want families across the country to feel safe when they walk through the doors of their maternity settings."
The Department for Health and Social Care reported that there have already been over 2,100 calls made under Martha's Rule, resulting in changes to patients' treatments. More than 600 of these calls led to potentially life-saving interventions, including transfers to enhanced levels of care.
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