Martha's Rule: getting the right help with it matters most

Healthwatch Swindon explored public awareness and understanding of Martha's Rule, a new NHS patient safety initiative that allows patients, families and carers to request an urgent clinical review if they are concerned that a hospital patient's condition is deteriorating. The project gathered feedback from 115 survey respondents, community outreach activities, workshops and hospital ward visits between April and June 2026.

The report found that awareness of Martha's Rule remains low, with only 43% of respondents having heard of it and many confusing it with services such as PALS. Despite this, there was strong support for the concept once explained: 65% said they would feel comfortable using it and 77% believed it could improve patient safety. 

Key Findings

• Awareness and understanding of Martha's Rule were limited, with many people unclear about its purpose. 
• Martha's Rule was frequently confused with PALS and other feedback routes.
• Most respondents believed it could improve patient safety and would be willing to use it if needed. 
• Participants wanted information to be widely available, particularly in hospitals, GP practices, community settings and online.
• People preferred a range of communication formats, including posters, videos, written guides and face-to-face explanations, rather than a single method. 
• Respondents highlighted the importance of accessible information, including easy-read and translated materials. 

Conclusion

The report concludes that there is strong public support for Martha's Rule, but much greater awareness and clearer communication are needed if it is to be used effectively. Healthwatch recommends a coordinated communication campaign, clearer differentiation from PALS, information at key patient touchpoints such as hospital admission, and the use of multiple accessible formats to ensure patients and families know how and when to raise concerns.