Martha's Rule launched at OUH

An initiative that gives patients, their loved ones, carers and staff 24-hour access to an urgent review when there are concerns about a patient’s worsening condition has officially launched at Oxford University Hospitals NHS Foundation Trust (OUH).

Following a successful pilot, the Trust has introduced Martha’s Rule in inpatient wards – including adult, children’s, neonatal, maternity and emergency department areas – at its four hospitals: the John Radcliffe Hospital, Churchill Hospital and Nuffield Orthopaedic Centre in Oxford, and the Horton General Hospital in Banbury.

The escalation service was developed nationally by NHS England to strengthen how concerns about patient deterioration are recognised and acted upon, following the case of 13‑year‑old Martha Mills.

The launch means inpatients being cared for at the Trust and those who know them best, along with staff, can request an urgent review from an independent, specialist team if they feel a patient’s condition is worsening and that their concerns have not been fully addressed.

The system strengthens existing safety processes, enhancing the level of care and ensuring concerns are heard and acted upon quickly and consistently.

Anyone wanting to use Martha's Rule in relation to OUH inpatients should call the Trust switchboard on 0300 304 7777 and quote 'Martha's Rule call'. This is available 24 hours a day, seven days a week.

Abi Mansfield, Project Manager for Martha’s Rule at OUH, said: "By introducing Martha's Rule across OUH, we are strengthening patient safety by ensuring anyone who is worried about an inpatient’s deterioration can trigger an urgent review.

"It builds on the safeguards already in place, empowering patients, families, carers and staff to speak up. It also brings greater consistency to how concerns are managed across our hospitals and reflects our commitment to delivering compassionate excellence."

Professor Andrew Brent, Chief Medical Officer at OUH, said: "Martha's Rule is an important step forward in how we support inpatients whose condition may be deteriorating. Families and carers play a crucial role in recognising subtle changes that may not yet appear in clinical observations, and their insights can help us act sooner.

"Our aim is simple: if someone is worried, they can get help quickly – and we will respond. Ensuring people feel confident to raise concerns is central to safe, high‑quality care."

Martha’s Rule is designed specifically for urgent concerns about acute clinical deterioration. For all other clinical issues, and for other more general issues, such as food, parking or general queries, patients and families should speak to ward staff or contact the Patient Advice and Liaison Service (PALS).

Further information is available on the Martha's Rule page on the OUH website.