An e-learning introduction to Martha’s Rule has been developed by NHS England, with support from the West of England Patient Safety Collaborative, to help NHS staff implement Martha’s Rule.
Martha’s Rule is a patient safety initiative that ensures the concerns of patients, families, carers and staff around deterioration are listened to and acted upon.
The training is aimed at all healthcare staff including nurses, clinicians, allied health professionals and support staff. It covers the origins of Martha’s Rule and its three core components and includes real-life case studies and practical scenarios. The programme also addresses barriers to escalation and the importance of equitable access for all.
Central to Martha’s Rule is the right for patients, families and carers to request a rapid review if they are worried a patient’s condition is getting worse and their concerns are not being addressed.
The first year of Martha’s Rule has resulted in earlier, potentially life-saving treatment for more than 1,700 patients, with roughly 400 transferred to enhanced levels of care.
Health Innovation West of England is one of NHS England’s key delivery partners for implementing Martha’s Rule across our region, working closely with colleagues from all three Integrated Care Systems.
Janet Scott, Patient Safety Lead at Health Innovation West of England commented: “Martha’s Rule is fundamentally about listening to patients, families and staff, and acting early when something doesn’t feel right. This e-learning provides a clear, practical introduction that will help teams across the NHS understand their role in escalation, overcome barriers, and embed Martha’s Rule consistently to improve patient safety and outcomes.”
Access the e-learning introduction to Martha’s Rule.
Find out more about our work to support the implementation of Martha’s Rule.
Posted on February 5, 2026
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