Every A&E department and hospital waiting room in England has officially implemented Martha’s Rule as of September 2026, providing a 24/7 safety net for patients and families who fear a medical condition is being overlooked.
The national rollout marks the final major phase of the initiative, which allows patients, their families, and hospital staff to trigger an urgent clinical review from an independent team if they believe a patient’s health is deteriorating and their concerns are not being addressed by the primary medical team.
For residents in Bognor Regis and the surrounding Chichester district, the scheme is already active at University Hospitals Sussex NHS Foundation Trust sites, including St Richard’s Hospital in Chichester and Worthing Hospital. The expansion to include A&E waiting areas specifically addresses concerns about patients becoming critically ill before they are even admitted to a ward.
A “lifeline” for patients
The rule is named after Martha Mills, who died of sepsis in 2021 at the age of 13. Her parents had repeatedly raised concerns about her worsening condition, but their warnings were not acted upon in time. Since the scheme’s initial pilot launch in 2024, it has become a vital component of NHS patient safety.
According to the latest NHS data, more than 10,000 escalation calls have been made via Martha’s Rule since its inception. Officials estimate that the intervention has potentially saved 446 lives. Demand for the service reached a peak in July 2026, which saw the highest-ever monthly total of 1,678 calls.
The process differs from a standard request for a second opinion regarding a diagnosis or treatment plan. It is specifically designed for “acute deterioration”—situations where a patient’s physical health is visibly declining and the current care team does not seem to be responding to the urgency of the change.
How to trigger the rule
Patients and families at St Richard’s, Worthing, and other hospitals across England can activate the review by calling a dedicated internal hospital helpline. Under the new mandate, this service must be available 24 hours a day, seven days a week.
Information on how to access the service, including the specific phone number for each site, is displayed on posters and leaflets in wards and A&E waiting areas. When calling the helpline, the person triggering the rule will typically be asked to provide:
- The patient’s name.
- Their current location (ward or waiting area).
- A brief description of the deteriorating symptoms or the specific reason for concern.
Once triggered, a rapid review is conducted by an independent team who are separate from the patient’s day-to-day medical team. This provides an objective assessment of whether the patient requires a higher level of care or a change in treatment.
The expansion of the scheme to every A&E department and hospital waiting room in England was implemented in September 2026.
Health officials have emphasised that the rule is also a tool for NHS staff. It empowers nurses and junior doctors to call for an independent review if they feel their concerns about a patient are being dismissed by senior colleagues within their own hierarchy.