In March 2025, we introduced a new patient safety service at the Trust called ‘Martha’s Rule’.
Martha’s Rule is a national patient safety initiative, which gives patients and families access to an urgent review if they are worried that the adult inpatient’s condition is getting worse.
Maidstone Hospital and Tunbridge Wells Hospital have been selected as two of the first 143 hospitals in England to implement Martha’s Rule as part of the first phase of the programme.
What does this mean?
Our expert teams have multiple processes in place to tell when an adult inpatient’s condition is getting worse. But as a friend or family member, you may be able to spot when things aren’t right early on.
If you’re worried they are getting worse, first of all, please speak to:
- The nurse looking after them
- The nurse in charge
- A doctor on the ward
However, if you are still worried, Martha’s Rule means inpatients and/or their relatives can call our direct number for immediate help and advice if they are worried the inpatient’s condition is getting worse.
When we receive your call we will need to know:
- the inpatient’s name
- the name of the ward
- a brief description of your concern
- your relationship to the inpatient and contact details
All telephone calls to this number will be assessed and, where appropriate, a nurse from our Critical Care Outreach Team (CCOT) will visit the patient on the ward to ensure they are receiving the suitable treatment and support. The service is available 24 hours a day, seven days a week.
You can also make a report about a patient by completing our online form.
Tunbridge Wells Hospital
- 0770 1211766
Maidstone Hospital
- 0770 1211768
When should I contact the Martha's Rule number?
You can call if you are worried that you, or your relative or friend is becoming more unwell despite treatment. In the first instance you should raise your concerns with the ward nurses and doctors. If you feel that your concerns have not been addressed appropriately or you have any on-going concerns after you have spoken to the ward nurse or doctor, then you should contact Martha’s Rule.
The service is currently available at MTW for adult inpatients only.
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.
When should I not make a call?
Martha’s Rule is only for concerns about unwell patients who require an urgent clinical response. For any general concerns, for example, nursing care, parking, facilities, complaints, please speak to the ward nurses or ward manager. You can also contact the matron to discuss any issues further.
Additional contact information
Our Patient Advice and Liaison Service (PALS) supports patients, carers and relatives who wish to raise concerns or share compliments. PALS works closely with those who contact them, and CSUs, to ensure concerns are responded to as soon as possible. Find out more information about PALS.
More about Martha’s Rule
The national initiative is named after Martha Mills, a 13-year-old girl who died from sepsis in 2021 after her family raised concerns about her condition.
The initiative has three main components:
- Patients will be asked, at least daily, about how they are feeling, and if they are getting better or worse, and this information will be acted on in a structured way.
- All staff will be able, at any time, to ask for a review from a different team if they are concerned that a patient is deteriorating, and they are not being responded to.
- This escalation route will also always be available to patients themselves, their families and carers and advertised across the hospital.