What is Martha’s Rule?
Martha’s Rule gives hospital patients, their families and carers a way to request a rapid review when a patient is becoming more unwell and their concerns are not being addressed.
It provides access to a separate clinical review team through the hospital’s local process. The central message is simple: changes noticed by patients and families deserve attention.
What is changing in England’s A&E departments?
An announcement on 22 September 2026 set out a phased expansion of Martha’s Rule to emergency departments in England, including waiting areas, with completion planned by March 2028.
The announcement does not mean every A&E already offers the service. Ask staff whether Martha’s Rule is available in that department and how to access it.
Martha’s Rule: your questions answered
When should I raise a concern?
Tell staff promptly if you believe a patient is getting worse. Describe what has changed and when you noticed it.
You do not need to know the diagnosis or use medical language to explain that something feels different.
Can a family member request a review?
Yes. Patients, families and carers can raise concerns about deterioration. Staff also have access to clinical escalation routes.
Someone who knows the patient well may notice a change from their usual behaviour or condition.
How do I access Martha’s Rule?
Speak to the nurse or doctor caring for the patient. If concerns about deterioration remain unresolved, ask for the local Martha’s Rule process.
The hospital may display a dedicated number on posters, leaflets or its website.
Is there one national phone number?
No single number should be assumed to work everywhere. Hospitals publish their own contact details and explain which areas their service covers.
Use the details for the hospital where the patient is receiving care. MDC’s contact number is not a Martha’s Rule helpline.
What if someone gets worse while waiting?
Tell the triage nurse or another member of staff immediately and ask for reassessment. Do not quietly wait for the original appointment order.
Ask about Martha’s Rule where available if deterioration concerns are still not being addressed.
Is Martha’s Rule a complaints service?
No. It is intended to address concerns that a patient is becoming more unwell.
General complaints about service or communication can be raised through the hospital’s complaints process or Patient Advice and Liaison Service (PALS). Urgent deterioration should be raised with clinical staff immediately.
Is it a general second-opinion service?
Its focus is an urgent review of deterioration. It is not a general route to request a different diagnosis, a particular test or a preferred treatment.
The reviewing team assesses the concern and decides what clinical action is needed.
What if it has not reached this department?
You can still raise concerns and ask for reassessment. Speak to the nurse in charge or treating doctor and explain that the patient’s condition has changed.
Ask what urgent escalation process is available locally. Do not wait for the rollout to seek help.
“I am worried they are getting worse.”
Be specific about the change. You could say:
“This is different from their usual condition. I noticed the change at [time]. I am worried they are deteriorating. Please reassess them and explain the next steps.”
If you remain concerned, add: “How can I request a rapid review through Martha’s Rule here?”
What information helps the clinical team?
- The change: explain what is different from earlier or from the person’s usual condition.
- The timing: say when it started and whether it is continuing or getting worse.
- Your previous concerns: explain who you have already spoken to and what happened.
- The patient’s location: have their name, department or ward ready if calling the local review service.
Being heard matters in every healthcare setting
The importance of listening extends beyond hospital wards. During a clinic appointment, patients should feel able to describe changing symptoms, ask questions and understand the next steps.
Explain what has changed
At an MDC consultation, tell the clinician about persistent, new or worsening symptoms, previous treatment and any concerns that have not been resolved.
Bring relevant results, discharge information and a list of medicines where available.
Ask what the results mean
Ask which questions your tests answer, what remains uncertain and whether further assessment is needed.
A result should be considered alongside your symptoms and clinical assessment. Do not ignore deterioration because an earlier test was reassuring.
Agree a clear next step
Before leaving, ask who will review outstanding results, how you will receive them and whether you need another appointment.
Ask what to do if symptoms persist or change before then.
Does MDC operate Martha’s Rule?
This article explains the NHS hospital initiative. MDC is not an A&E department or an NHS Martha’s Rule review service.
For concerns during an MDC visit, tell the clinical team immediately. Non-emergency enquiries can be made through our contact page.
Questions about non-emergency care?
Contact Marylebone Diagnostic Centre to discuss arranging a clinical consultation or to ask about an existing appointment or test result.
Marylebone Diagnostic Centre
73 Baker Street, London W1U 6RD
