Implementing Martha’s Rule in Paediatric Care

‘Failure to rescue’ in hospital patients is linked to around five potentially avoidable deaths in every NHS trust in England each month. A common cause is that patients’ and families’ concerns about deterioration are not acted on. Martha’s Rule aims to change this by creating reliable pathways for patients and families to raise concerns. One of these requires care teams to check in with patients and families at least once a day. This research explores how these check-ins are carried-out and experienced in paediatric care, where age and family roles shape how concerns are raised and heard.

The study is taking place in four NHS hospital trusts and includes interviews with children, families, and hospital staff, as well as surveys to understand views on the check-ins, and ward observations to see how they happen in day-to-day care. It aims to see whether the check-ins help all children, young people, and their carers feel able to speak up and be heard, how their concerns are escalated when needed, and why this may be so. The primary goal is to inform the implementation of Martha’s Rule in paediatric care so that escalation processes are effective, inclusive, and meaningful for everyone.