Martha’s Rule: detecting deterioration

You know yourself or your loved one better than anyone. If you’re worried about a health condition getting worse, talk to us.

What is Martha’s Rule?

We have introduced Martha’s Rule to help spot any unexpected signs of deterioration early and give you the right to request a rapid review if you’re worried that your or your loved one’s condition is getting worse.

You may notice small changes before they show up in our routine measurements. These changes could be early warning signs of deterioration.

How we monitor patients

While someone is in hospital, we regularly check their vital signs and other important health measurements. The frequency of these checks will depend on the patient’s individual condition and needs. Sometimes we may need to wake patients to do these checks.

Your role is vital

To help us detect the early signs of deterioration, please tell us if you are worried about:

Changes in temperature – hot or cold to the touch
Worsening pain
Any changes to the skin (eg rash)
Low energy, drowsy or sleepy
Levels of hydration
Changes in breathing
New confusion
Anything else that worries you

Telling our staff about these changes can help us to detect deterioration early so we can take action to prevent more serious health problems.

What to do if you’re worried

First, speak to the team caring for you or your loved one.
If, after speaking to the care team, you remain worried and feel your concerns are not being addressed, call for a rapid review. (The phone number for the Martha’s Rule service is given to patients on admission to the ward.)

Your call will go to a different team in our hospital, who specialise in the care of critically ill patients. They will work with you and your care team to arrange any treatment needed or further review.

The service is available 24 hours a day, seven days a week.

Our commitment

We will regularly ask for your views and take your concerns seriously. We see you as a partner in the care we are providing and want you to raise any worries and concerns you may have.

You are not bothering us – we want to hear from you.

Find out more about Martha’s Rule:
https://www.england.nhs.uk/patient-safety/marthas-rule/information-patients-families-carers/