A new 24/7 WhatsApp service for patients and their families to raise concerns about deterioration goes live today.
Martha’s Rule is a national patient safety initiative, brought in after the death of 13-year-old Martha Mills in 2021. Martha developed sepsis in hospital, after being admitted with a pancreatic injury after falling off her bike. Her 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.
Under Martha’s Rule, anyone – the patient, their family, carer or even a staff member – worried that someone’s health condition is getting worse, whilst they are in hospital, can request another team to review their care and treatment.
Now, local hospitals under NHS Humber Health Partnership are introducing an innovative way for people to request a review under Martha’s Rule. From today people can get help with Martha’s Rule via a new WhatsApp channel. Staff can also use the service if they feel their concerns about a patient deteriorating are not being listened to or acted on.
The service is for anyone to raise concerns the health of an inpatient in hospital is getting worse. Posters on wards will have a QR code on them which people can scan. They’ll be taken to a chat which will ask them a series of questions. Any general concerns about care and general queries will be routed to the right team; importantly freeing up the Critical Care Outreach Team to respond to the calls where deterioration is a factor.
Anyone who cannot use WhatsApp can call the Critical Care Outreach Team directly.
Mr Peter Sedman, Deputy Chief Medical Officer for NHS Humber Health Partnership, said: “Martha’s Rule actively encourages patients, families and carers to tell staff if they are worried a health condition is getting worse. We know that loved ones often notice small changes that could be early warning signs of deterioration before they show up in routine measurements.
“We will always encourage people to first raise their concerns with the team looking after the patient. If, after speaking to the care team, they remain worried and feel their concerns are not being addressed, Martha’s Rule means that they can contact a dedicated team, Critical Care Outreach, to request a rapid review.”
Nationally data shows only a third of the concerns raised under Martha’s Rule related to acute deterioration. The new WhatsApp service, which has proved to be successful at Alder Hey NHS Children’s Foundation Trust, will help triage Martha’s Rule concerns ensuring other non-urgent queries are directed elsewhere.
NHS Humber Health Partnership has teamed up with LINK Mobility UK to develop the WhatsApp solution. John Hayes, Managing Director for LINK Moblity UK, said: “The WhatsApp Business solution supports structured, two-way communication, where families are guided through a defined journey and can respond to prompts in a simple, effective way to collect important information.
“This helps ensure concerns are captured clearly, consistently and safely. The aim is not to replace conversations with clinicians, but to give families a way to raise concerns that feels both accessible and structured – giving families a frictionless mechanism to request a rapid clinical review without needing to navigate hospital switchboards or complex escalation pathways.
“We’re pleased to be able to support NHS Humber Health Partnership in this important project that will positively affect their patients experiences and lives and supports the wider Martha’s Rule initiative throughout the NHS.”
National data from September 2024 to April 2026 shows 14,654 Martha’s Rule calls were made, with the highest proportion of calls (72%) made via the family/carer escalation process. 4,632 Martha’s Rule escalation calls (32%) related to acute deterioration.
Of those, 2,720 calls required changes in treatment. This includes 616 calls which resulted in transfers of care to high dependency or intensive care units, enhanced levels of care, tertiary centres or referral/transfer to specialists or a specialist ward. Other changes in treatment (2,104) did not require transfer of a patient from a ward in-patient setting. This includes the introduction of a new medication such as an antibiotic to treat infection, investigations including scans and procedural interventions including going to theatre.
Where calls were not categorised as being related to acute deterioration, they are still supporting staff to provide better care and address concerns. For example, 3,699 calls led to clinical concerns such as medication or investigation delays being addressed. A further 3,673 calls helped to resolve communication and discharge planning issues.