Martha’s Rule is a patient safety service run by our Acute Care Response Team (ACRT), to help spot signs of deterioration early.

You can ask for a rapid review if you’re worried that you or your loved one’s condition is getting worse.

You may notice small changes before they show up in our routine measurements, these changes could be early warning signs of deterioration.

The service is available for inpatients of all ages, and is available 24 hours a day, seven days a week.

Help us spot the early signs of deterioration 

You might notice these things:

  • Changes in skin temperature – hot or cold to the touch
  • Worsening pain
  • Any changes to the skin (e.g. rash or being mottled)
  • Drowsy or sleepier than normal
  • Changes in breathing
  • New confusion
  • Anything else that worries you

Telling our staff about these changes can help us to detect deterioration early, so we can take action to prevent more serious health problems.

How do you use Martha's Rule: Call for Concern?

If you are worried:

  1. Speak to the team caring for you or your loved one.
  2. If you are still worried ask to speak to the Nurse in Charge or Ward Manager.
  3. If you have done this and remain worried and feel that your concerns are not being addressed, you can call for a rapid review from the Acute Care Response Team on 01793 604534. You will need the patient’s name, the ward or department that they are in, and details of your concern.

The Acute Care Response Team will work with you and your care team to arrange any treatment or further review if needed.

When is Martha’s Rule: Call for Concern not the right service to use?

You or your loved one are getting better: Martha’s Rule is a patient safety service for patients that are unwell and getting worse, it is not to be used to talk about any general problems about a patient’s stay in hospital. Please discuss this with the Nurse in Charge, Ward Manager or the Patient Advice and Liaison Service (PALS).

You want a second opinion: Martha’s Rule allows hospital inpatients and/or their families to seek a rapid review if they are becoming more unwell. A second opinion is a process where patients, families or carers can ask to see another consultant to discuss any diagnosis or treatment. For more information about second opinions, please talk to your ward team.

The person you are calling about is not in the Great Western Hospital: Martha’s Rule calls should only be made about people who are current inpatients in Great Western Hospital. For outpatient queries please contact your GP, NHS 111, or in an emergency call 999.