One year on from implementing Martha’s Rule at CHFT, Martha’s Rule Matron, Joanne Briggs, takes us through how the nurse-led initiative has strengthened early recognition of deterioration and communication.

For those who don’t know, can you explain what Martha’s Rule is?

"Following the sad death of Martha Mills, NHS England created a patient safety initiative to support the early detection of deterioration. At CHFT it was vital to us to create a clear escalation route for all patients, carers, staff and advocates in our inpatient Adult and Paediatric wards to empower families, carers, patients or colleagues to raise urgent concerns if they feel a patient’s condition is worsening and and they are not being responded to."

 What did we want to achieve from Martha’s Rule at CHFT?

"We wanted to create advanced nurse‑led early recognition of deterioration by using Martha’s Rule to escalate concerns before NEWS2 rises, strengthen professional‑concern escalations and improve communication.

"From the outset we involved colleagues from across teams, including Medical, Surgical and Paediatric leads, Communications, Experts by Experience, Business Intelligence and Nursing.

"We now have a clear escalation route, with processes, policies, and strong awareness of Martha’s Rule across our inpatients Adults and Paediatrics wards.

"It was also important that our patients and families felt heard and that they could see that Martha’s Rule is beneficial."

How is Martha’s Rule going after a year?

"Thanks to involvement of lots of colleagues, Martha’s Rule has been successfully implemented across the Trust.

"The support of the BI team has been invaluable as we have been able to make the most of the digital tools we have available to track how it’s going. Our electronic dashboard has provided transparency, identification of trends and supported learning at ward and organisational level and digital auditing has supported sustainability and improvement.

"I have been lucky enough to have been asked to present the work to other NHS Trusts across the country as an example of best practice, including the recent Bristol Patient Safety Competition,  and our approach to using digital has also recently been used as an NHS England national case study too."