NHS to Expand Martha’s Rule to All A&Es

NHS England has announced a major patient‑safety milestone: Martha’s Rule will now be expanded to all A&E departments and waiting rooms across England, following successful pilots in seven trusts and thousands of life‑saving interventions since its introduction.

This expansion means that patients, families and staff in busy emergency departments will be able to call a dedicated Martha’s Rule phone number if they are worried that someone’s condition is deteriorating and feel their concerns aren’t being heard. It’s a critical safeguard in environments where early escalation can save lives.

The phased roll-out – to be completed by March 2028 – comes as the NHS faced the busiest summer in its history this year, with nearly a quarter of a million (241,061) more attendances to A&E in June, July and August than in 2025.

[https://www.england.nhs.uk/2026/09/nhs-to-expand-life-saving-marthas-rule-to-all-aes/] 

We want to ensure ALL patients have equitable access to the programme, and encourage NHS organisations to ask themselves 'Can non-English speaking patients access the service as quickly and easily and English speaking patients?' during implementation.

A reminder: what is Martha’s Rule?

Martha’s Rule is a national patient‑safety initiative named after Martha Mills, who tragically died aged 13 after developing sepsis in hospital. Despite her family’s repeated concerns, her deterioration wasn’t escalated – and a coroner later ruled she would likely have survived had she been moved to intensive care earlier.

Martha’s Rule was created to ensure this never happens again.

It gives patients, families and staff a clear, structured way to raise concerns about deterioration and request an urgent clinical review, even from a different team, if they feel something isn’t right. Since rollout began, more than 19,000 calls have been made, many leading to changes in treatment, transfers to intensive care, and life‑saving interventions.

Why expansion to A&E matters

A&E departments see some of the NHS’s most vulnerable patients - people arriving in crisis, and conditions are often changing rapidly, with quick decisions necessary to provide care and save lives.

The NHS pilot showed that Martha’s Rule can work safely and effectively in fast‑paced emergency environments, providing:

• A critical new lifeline for patients and families
• Faster escalation when deterioration begins in waiting rooms
• Additional safeguards without requiring extra clinical staff
• A culture shift where speaking up is encouraged, expected and acted on

This is patient safety in action – practical, responsive, and rooted in listening.

Where language support for Non-English Speaking patients come in

Policies like Martha’s Rule work most successfully when every patient can use them.

For people who face language barriers, knowing how to raise concerns and having the words to do so, can be the difference between being heard and being missed.

A key aspect of Martha's Rule, is a dedicated escalation phoneline that can be called at any point to get further advice and clarification – Wordskii Connect can ensure patients or their families are able to access this service with an interpreter already on the line for easy communication.

We have also created a pre-translated Phrases feature which was designed with policies like Martha’s Rule in mind. Part of Martha's Rule includes patients being asked if they are feeling better or worse than the day before, and so this routine interaction can be available in over 100 languages at the press of a button.

It provides:

• Clear, pre‑built translated phrases in 100 languages
• Quick ways to express deterioration, pain, or urgent concerns
• Support for families who need to escalate but cannot communicate well in English
• A bridge between clinical teams and patients who need to be understood fast

Martha’s Rule empowers patients to speak up. Language support, especially tools that are immediately available within emergency departments, helps make sure everyone can.

A shared mission: safer care through better communication

The expansion of Martha’s Rule to all A&Es is a landmark moment for patient safety. It reinforces something we see every day at Word360: when communication is clear, care becomes safer.

As the NHS continues to strengthen escalation pathways, we remain committed to ensuring that language is never a barrier to being heard – especially when it matters most.

You can read about this in further detail on the NHS England’s website: https://www.england.nhs.uk/2026/09/nhs-to-expand-life-saving-marthas-rule-to-all-aes/