Concerned your or a loved one’s health is getting worse?
There is support available to you.
Call for Concern, also known as Martha's Rule, is a patient safety service for adult inpatients, children and young people, families and friends to call for help and advice if they or their family are concerned that there is a noticeable change or deterioration in their condition, and they are concerned this is not being responded to.
Barts Health is part of the 143 hospitals to pilot the implementation of Martha’s Rule. Please beware that not all wards are able to offer Call for Concern currently.
When should you use Call for Concern?
When should you use Call for Concern
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When there is a significant change in the patient’s condition and, after a discussion with the health care team, concerns have not been addressed
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When it is not clear what the plan is for the patient following a discussion with the health care team.
What happens next?
Once contacted, the team may provide advice over the phone or, depending on the issue, they will visit the ward to discuss your concerns further.
You may be asked to provide the following information:
· The patient’s name
· The ward they are on
· A brief description of the problem and what has already been done about it
· Your contact details and relationship to the patient
When not to use Call for Concern
Call for Concern is a patient safety service.
This service should not be used to report general problems regarding a patient’s care, for example, issues with the hospital bed, room, food, parking etc. Please read the different ways you can share feedback or raise more general issues.
Additional information
Call for Concern includes three components to ensure concerns about deterioration are swiftly addressed:
- An escalation process will be available 24/7 within participating wards, allowing patients and families to contact a clinical team that can quickly assess a case and escalate care if necessary.
- NHS colleagues will have access to this same process if they have concerns about a patient's condition.
- Clinicians in participating wards will formally record daily insights and information about a patient's health provided by their families, ensuring that any concerning changes in behaviour or condition noticed by those who know the patient best are considered by staff.
Some changes that you may notice before anyone else:
- The patient seems different to usual (not themselves)
- Breathing differently
- Sweating or unusual skin colour
- Reduced urine output or not passing urine
- More sleepy than usual or confused
- Hands feel cold or very hot
- In pain and looks uncomfortable
- You are worried about their condition.
Difference between Martha’s Rule and second opinion
Martha’s Rule allows hospital inpatients and their families to seek an urgent review if their condition, or the condition of a loved one, is deteriorating.
A second opinion is when you would like to see another consultant to discuss any diagnosis or treatment.
Martha Mills and Martha’s Rule
Martha Mills died in 2021 after developing sepsis whilst being treated at hospital, where she had been admitted with a pancreatic injury after falling off her bike.
During her stay, Martha’s family’s concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier.
In response to this, campaigning from Martha’s parents, and other cases related to the management of deterioration, the Department of Health and Social Care and NHS England agreed to implement ‘Martha’s Rule’, which is designed to ensure the vitally important concerns of patients, and those who know the patient best, are listened to and acted upon.
Contact us
If you are worried
- St Bartholomew's Hospital: 07743930950
- Whipps Cross Hospital (Curie and Primrose Wards): 07919211646