Martha’s Rule Brings Right to Second Opinion in NHS A&E Departments

By the Editorial Team · Tuesday, September 22, 2026

England’s NHS will expand Martha’s Rule to all A&E departments by March 2028, allowing patients, relatives, and staff to urgently request second opinions on care if concerns arise. This move aims to enhance patient safety by ensuring quicker interventions in emergency settings, building on positive results from trials and prior inpatient ward implementations.

England’s National Health Service (NHS) is set to extend Martha’s Rule, which grants patients, relatives, and staff the right to urgently request a second opinion on care, to all Accident & Emergency (A&E) departments across the country by March 2028. The initiative aims to improve patient safety by ensuring concerns about deteriorating conditions are promptly addressed.

Martha’s Rule was introduced following the 2021 death of 13-year-old Martha Mills, who died of sepsis at King’s College Hospital in South London. An inquest found that earlier intervention, including timely transfer to intensive care, could have saved her life. Her parents, Merope Mills and Paul Laity, had repeatedly raised concerns about her condition while she was hospitalized, but felt these were dismissed by medical staff.

The rule has previously been implemented in inpatient wards, where since September 2024 more than 19,000 calls have been made to request a second opinion. The service includes a dedicated phone line that allows staff, patients, or family members to escalate concerns if a patient’s condition appears to be worsening unchecked. A trial in seven NHS trusts’ A&E departments over eight months resulted in 69 calls, some of which led to urgent surgery or transfers to intensive care.

Professor Aidan Fowler, NHS England’s national director of patient safety, emphasized the importance of the extension, noting that A&E departments treat some of the most vulnerable patients. He stated that the early testing demonstrated the rule’s effectiveness in busy emergency settings and builds on successes seen in adult and children’s wards, where the service has already contributed to treatment changes and potentially life-saving interventions.

Health Minister Baroness Merron described the expansion as part of broader NHS efforts to prioritize patient safety and provide an additional safeguard for those receiving care in emergency settings.

As Martha’s Rule is implemented across all A&E departments over the next two years, it is also planned to expand the service to maternity and neonatal units, extending the availability of rapid second opinions across more critical areas of the NHS. This multifaceted approach reflects a growing commitment to ensure that patients and their families have a stronger voice in hospital care and that concerns are acted upon swiftly.

This article was reported by synthesizing coverage from multiple independent news outlets to present a balanced, unbiased account. Read about our editorial standards. Spotted an error? Let us know.