Martha’s rule: Government considers call for right to second medical opinion after girl’s sepsis death in London hospital

Martha Mills, 13, tragically died after treatment failures at King’s College Hospital  (MEROPE MILLS)
Martha Mills, 13, tragically died after treatment failures at King’s College Hospital (MEROPE MILLS)

The parents of a teenager who died in a London hospital two years ago have called for patients and their loved ones to be given the right to an urgent second opinion if they feel they are not being listened to.

Martha Mills died aged 13 in 2021 after sustaining a laceration to her pancreas from a bike accident on a family holiday in Wales. She later developed sepsis while being treated at King's College Hospital, in Camberwell.

An inquest into her death heard that she would have survived had consultants made a decision to move her to intensive care sooner. Martha, described by her parents as “bright, healthy, enthusiastic”, would have been 16 on Monday.

In a Prevention of Future Deaths report issued after the inquest, senior coroner for Inner North London Mary Hassell wrote: “Whilst at King’s Martha was not referred to the paediatric intensivists promptly. If she had been referred promptly and had been appropriately treated, the likelihood is that she would have survived her injuries.”

Martha's mother Merope, a senior editor at the Guardian, told BBC Radio 4's Today programme that her family's concerns were not taken seriously by doctors and claimed that they were “not given the full picture” about her deteriorating condition.

Think tank Demos and Ms Mills on Monday published a report which is calling on the NHS to put in place “Martha's rule”, which would allow patients or their loved ones to request a review from a separate team of clinicians if they feel they are not being heard or responded to.

Health Secretary Steve Barclay said in the Commons on Monday he has asked his department and the NHS to look at whether it can introduce the measures in a bid to improve patient safety.

He said: "Martha's rule would be similar to the Queensland system called 'Ryan's rule' - it's a three-step process that allows patients or their families to review a clinical review of their case from a doctor or a nurse if their condition is deteriorating or not improving as expected.

"Ryan's rule has saved lives in Queensland and I've asked my department and the NHS to look into whether similar measures could improve patient safety here in the UK."

The Demos report notes that such a system, named Call 4 Concern, already exists at Kingston Hospital and the Royal Berkshire Hospital, in Reading. The service enables patients and families to seek immediate help when they feel that a healthcare team has not recognised their own or a loved one’s condition.

It said: “These schemes give patients a direct line to ask a separate clinical team to request a review, or a second opinion. Research in hospitals that have adopted it have found that it improves treatment in lifesaving ways and is rarely abused. It requires thoughtful implementation but has proved manageable and effective.”

Ms Mills told the broadcaster: “I genuinely believe that good doctors should welcome good input from patients or family members - who are the other experts in the room - and they should certainly welcome the input and second opinion of another doctor.”

A spokesperson for King's College NHS Trust said they were “deeply sorry that we failed Martha when she needed us most”.

“Since Martha’s death, we have put a number of improvements in place to help identify deteriorating children early, including mandatory sepsis training for all clinical staff in paediatrics.

“We have established a new Paediatric iMobile service, which involves a specially trained team reviewing any seriously unwell children on our wards, and escalating their care where necessary.”

The Trust said it now formally documents parental concerns on an “electronic paediatric early warning chart” and has put guidelines in place to recommend escalation of a child's care when they are unable to provide “sufficient reassurance” to parents.

An NHS spokesperson said: “All patients and families are able to seek a second opinion if they have concerns about their care and, as professional guidance for doctors in England sets out, it is essential that any patient's wishes to seek a second opinion are respected.”