The programme's expansion followed a pilot in seven trusts to test whether the escalation process could work safely and effectively in busy and fast-paced A&E environments.
Professor Aidan Fowler, national director of patient safety at NHS England, said: ‘Martha's Rule is already having a transformative effect in making our acute care even safer, and by expanding Martha's Rule into A&Es, we are giving even more patients, their families and NHS staff a critical new lifeline to help improve care and save more lives.'
Latest figures for July 2026 show the highest ever monthly total of calls made via Martha's Rule (1,678) and since September 2024 to July this year, more than 19,000 (19,177) calls have been made by patients, their families and NHS staff.
The initiative is named after Martha Mills, who died in 2021, aged 13, after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling off her bike.
Matthew Hopkins, director of The NHS Alliance's acute and ambulance network, said: ‘NHS leaders welcome the roll out of Martha's Rule to all hospital A&E departments and waiting rooms, following the initial pilot in seven trusts. They support the initiative's aim to give the most vulnerable patients, families and staff the chance to be heard and raise concerns.
‘This will enhance the safety of care and will provide reassurance for patients and their families if there are concerns that the patient's condition is getting worse.'
Kat James, managing director NHS telemedicine provider, Consultant Connect, said: ‘The value of being able to quickly seek a second clinical opinion is something we see across the NHS. Through Advice and Guidance, GPs and other frontline clinicians, including paramedics, can speak directly to hospital consultants for specialist advice when they are unsure about the right course of action.
‘Having rapid access to that additional expertise can give clinicians greater confidence in their decisions, help make sure patients are directed to the right pathway first time, and ensure those who need specialist or hospital care receive it as quickly as possible.
Martha's Rule reinforces an important principle: whether a concern is being raised by a patient, their family or a clinician, it should be straightforward to seek another clinical perspective when it is needed.'
