Hospitals trust pioneers right to a ‘rapid review’
THE County Durham and Darlington NHS Trust (CD&D) is to be the first in the North East to adopt “Martha’s Rule”, which gives families the right to a “rapid review” if they’re worried their loved one’s health is getting worse while in hospital.
The trust has already been operating a similar second-opinion system called “Call 4 Concern” for around two years so is now in a good position to adopt the new rules - and it will be among the first NHS organisations to apply for NHS England support to bring in the change.
Martha’s Rule comes after the death of 13-year-old Martha Mills in 2021, who developed sepsis while under the care of an NHS trust in London following an abdominal injury.
Her parents Merope Mills and Paul Laity raised concerns about Martha’s health a number of times but these were brushed aside. The pair have since campaigned for Martha’s Rule to be introduced to give families more say.
In February, NHS England confirmed it would roll the change from April, formalising access to a critical care team for a second opinion.
The CD&D trust will be the first in the region to get the rule up-to-speed, health bosses said. In a report, North East and North Cumbria NHS Integrated Care Board’s deputy chief executive David Purdue said: “The implementation of Martha’s Rule ... will take a phased approach, beginning with at least 100 adult and paediatric acute provider sites who already offer a 24/7 critical care outreach capability.”
The first phase of this will see a “standardised approach” to the three parts of Martha’s Rule agreed - these require that NHS staff, and patients and their families, must both have 24/7 access to a critical care outreach team able to deal with concerns. The service and how to contact it must be advertised in hospital settings, and the NHS has to “implement a structured approach” to obtaining information about a patient’s condition directly from families and carers.
NHS bosses at a meeting of the ICB before Easter said there was a need to ensure “deep-seated cultural issues” were tackled. The idea of doctors dismissing concerns raised by Martha’s family was partially attributed to an outdated “doctor knows best” attitude.
Mr Purdue told the meeting that the NHS trusts in our region were at different stages when it comes to their readiness to bring in the changes, with the requirement to have the critical care outreach team available out-of-hours a “stopping block” in some areas. However this is something all trusts are working on.
Mr Purdue added that when it comes to patient deterioration and preventing avoidable harm, two factors - the early identification that someone had developed sepsis (blood poisoning), and the early identification that someone’s condition is deteriorating - were vital.
The hope is that Martha’s Rule will see improved safeguards and changes in working culture to ensure issues are spotted promptly. At least 100 NHS trusts are expected to bring in Martha’s Rule in the first phase, over the coming 18 months, with the programme evaluated throughout this year and next.