'Workarounds' needed for full Martha's Rule use

A new NHS scheme allowing patients and families to ask for an urgent second opinion if a patient's condition deteriorates will be rolled out at Guernsey's emergency department, health leaders say.

Martha's Rule is due to be in place at all NHS England hospitals by March 2028 following the death of Martha Mills, who died from sepsis after family concerns were not listened to.

Health and Social Care President George Oswald said Guernsey would follow the guidance and timeframes, but it will be "more difficult" for maternity services.

He said: "In terms of the breadth of experience and what staff we have available to provide the appropriate service in those particular areas... is more difficult."

He said workarounds would include contact with Jersey or the UK "when the need arises".

"I'm not talking about video-linking, the time required for Martha's Rule is such that you can't set up a video link in that time.

"But you can certainly set up a telephone consultation in that time."

Martha Mills was admitted to Kings College Hospital in London after a cycling accident in summer 2021 which left her with serious pancreatic injuries, before developing sepsis. She died aged 13.

A coroner ruled in 2022 she would have probably survived if she had been transferred earlier to intensive care and given appropriate treatment.

Oswald said there was currently "adequate provision 24/7" at the hospital.

He said: "The outreach team from the intensive care unit is particularly playing an important role in this and they could, of course, outreach to any area where a patient is deteriorating.

"It is more difficult in areas where the breadth of experience or availability staff locally is matches the size of our hospital and our community.

"In those circumstances, we are looking at workarounds to exactly satisfy those issues."

Deputy Hayley Camp questioned the reason for "jumping to a rule" if the provision was already there.

Oswald said it was a "good point" but it was appropriate to "formally align" with the NHS.

The three core components are:

• Patients will be asked at least daily, about how they are feeling, and if they are getting better or worse. This information will be acted on in a "structured way"

• All staff will be able, at any time, to ask for a review from a different team if they are concerned that a patient is deteriorating, and they are not being responded to

• Patients and loved ones in emergency units will also be able to call a phone number to trigger a rapid review if a patient's condition is deteriorating and they are concerned this is not being taken on board

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