Martha's Rule gives patients, families and carers a way to ask for an urgent review by a different clinical team when they are worried that someone in hospital is getting worse and feel their concerns are not being heard. At the Lister Hospital in Stevenage, East and North Hertfordshire Teaching NHS Trust calls it "Call for Concern", and you use it by calling the number shown on posters around the hospital.
To talk anything through with someone local, our Hitchin team is on 01462 534739.
Having a parent in hospital is tiring and unsettling, even when the care is good. You know your mum or dad better than anyone, and you are often the first to notice that something is not right.
This guide explains what the rule lets you do, how it works at the Lister, what is worth writing down, and how to plan the journey home so the same worries do not follow your parent back to Hitchin.
What is Martha's Rule?
It is a patient safety initiative led by NHS England. Its aim is to spot deterioration early by making sure concerns from patients, families, carers and staff are heard and acted on.
NHS England says it was developed in response to the death of Martha Mills and other cases. Martha Mills died in 2021, aged 13, after developing sepsis in hospital. A coroner ruled in 2023 that she would probably have survived had she been moved to intensive care earlier.
NHS England describes three core parts:
- Patients are asked at least daily how they are feeling, and whether they are getting better or worse.
- Any member of staff can ask a different team to review a patient they are worried about, at any time, if they are not getting a response.
- The same route is open to patients, families and carers, and is advertised across the hospital.
You can read the detail on NHS England's page.
How Martha's Rule works at the Lister: Call for Concern
East and North Hertfordshire Teaching NHS Trust runs the Lister Hospital. Its Call for Concern page, published on 30 July 2026, says the trust was one of the first to roll it out.
According to the trust, Call for Concern covers the wards, maternity, children's services, and the children's and adults' emergency departments at the Lister. It is designed to give a voice to patients and their loved ones when they think a patient is not improving and feel they are not being listened to.
You call the number advertised on posters throughout the hospital. The Critical Care Outreach Team listens to every call and makes sure the right person deals with the concern. If the patient is getting worse, they arrange a rapid clinical review.
The trust is clear that this review is independent of the ward team and is not a criticism of them.
The trust is also rolling out a daily wellness check on its wards, asking patients how they feel compared with the day before. It is a good moment to mention any worry.
When to use it, and what to do first
NHS England's guidance is that families should speak to the care team first. The rule is there if you remain worried that your parent's condition is getting worse and you feel your concerns are not being addressed.
In practice, that means three steps:
- Tell the nurse or doctor on the ward what you have noticed, as specifically as you can.
- If you are still worried and feel unheard, look for the Call for Concern posters and call the number shown.
- Explain who the patient is, where they are, and what has changed.
If someone at home becomes seriously unwell, call 999. For health worries that are not an emergency, NHS 111 or the GP is the right route.
What to note down while your parent is in hospital
Clear notes help any clinician see quickly what has changed, and help you stay calm when tired.
Useful things to record include:
- How your parent is normally: their usual memory, mobility, appetite and way of speaking.
- What has changed, and roughly when you first noticed it.
- Who you spoke to on the ward, when, and what they said.
- Any questions you are still waiting to have answered.
The "normal" part is often the most useful. HCPA, in guidance written for care providers, makes a similar point: care professionals often know the people they support extremely well and can spot subtle changes, which matters especially for people living with dementia or communication difficulties.
Is the rule coming to more A&E departments?
NHS England announced on 22 September 2026, as reported by ITV News, that the rule will be extended to all hospital A&E departments in England. The phased roll-out is due to finish by March 2028.
HCPA's summary of 7 October 2026 notes that the roll-out includes waiting rooms. Because it is phased, it will not be in every emergency department yet, so it advises checking the hospital or trust website, or asking staff, for local arrangements. At the Lister, the trust's own page already lists the emergency departments as covered.
Planning the return home to Hitchin
Speaking up in hospital is half the picture. The other half is making sure the same worries are not repeated once your parent is home.
Before discharge, ask the ward team what to watch for, who to call if things change, and what support is planned. Your hospital notes become the starting point for care at home.
Our guide to home care after hospital in Hitchin covers the local options in more detail. For how the hospital discharge team and council support fit together, see home care after hospital in Hertfordshire.
How home care can help after a hospital stay
Visiting care gives a returning patient a familiar face at each visit and gives the family someone who notices change. Our post-hospital care is built around familiar carers, consistent visit times and a care plan agreed with the family.
That plan can include the things you noted in hospital: what "normal" looks like for your parent, and what would be a reason to call the GP or NHS 111. We are a CQC-regulated home care provider, and our local Hitchin team supports families across the town and nearby villages such as Ickleford and Great Offley.
Visiting care is from £34 an hour, and live-in care is from £255 a day, or from £295 a day for couples. These are starting rates, and a price is agreed after an assessment.
You can reach our Hitchin team on 01462 534739 or at hitchin@starlinghomecare.co.uk, and read more on our Hitchin page.
Common questions about Martha's Rule in Hitchin
Can a family member ask for an urgent review?
Yes. NHS England says the route is open to patients, families and carers. It is intended for when you remain worried that a patient is getting worse after speaking to the care team, and feel your concerns are not being addressed.
What is Martha's Rule called at the Lister Hospital?
East and North Hertfordshire Teaching NHS Trust calls it Call for Concern. You use it by calling the number shown on posters around the hospital, and the Critical Care Outreach Team takes the call.
Will using Call for Concern upset the ward staff?
The trust says the rapid clinical review is independent of the ward team and is not a criticism of them.
Does Martha's Rule cover A&E?
At the Lister, the trust says Call for Concern covers the children's and adults' emergency departments. Nationally, NHS England is extending it to all A&E departments in phases, due to finish by March 2028.
Raising a concern about someone you love is never easy, but Martha's Rule means there is a clear, recognised way to be heard. Good notes, a calm conversation with the ward and a planned return home all help your parent recover with fewer surprises.
Details checked against NHS England, East and North Hertfordshire Teaching NHS Trust, HCPA and ITV News pages on 19 October 2026. Our prices are starting rates, checked on the same date.
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