Patients and families who are concerned that they are deteriorating while in hospital are now able to request a review from the critical care team.
North Cumbria Integrated Care NHS Foundation Trust has officially rolled out Martha’s Rule, (known as Call for Concern) across its hospital sites, reinforcing its commitment to patient safety, transparency, and compassionate care.
Martha Mills died in 2021 after developing sepsis in hospital, Martha’s family’s concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that Martha, aged 13, would probably have survived had she been moved to intensive care earlier.
Call for Concern has now been in place since the start of the year, with posters around the hospital sites directing people to call Cumberland Infirmary on 07769 248 453 or West Cumberland Hospital, 07827 983 964 if you feel your or a loved one’s condition is deteriorating. The call will be answered by the critical care team who will arrange for an urgent review.
As part of call for concern, teams have also introduced a ‘Patient Wellness questionnaire’ a tool designed to spark meaningful conversations about how patients feel their treatment is going, whether they feel they’re improving, and if they have any concerns.
The questionnaire stays with the patient from the point of admission and each day a health care professional will ask the questions to determine if the patient is feeling they are improving. If a patient, family member, loved one or any other member of staff feel a patient is deteriorating and feel the patient would benefit from a clinical review, they can call the Critical Care Outreach team who will action the call.
Lindsay Twentyman, Critical Care Outreach nurse at NCIC said:
“On a busy ward, it’s easy for subtle changes in a patient’s condition to be missed. These questionnaires give us a structured way to check in, listen, and act. We also know that family and friends know their loved ones best and can spot signs of deterioration quickly, giving them access to another way to escalate concerns has been received really well.”
Call for Concern was initially piloted on 4 wards across the Cumberland Infirmary and West Cumberland Hospital, before becoming accessible to all wards. The rollout has been met with enthusiasm from staff across departments. Teams are already reporting that the wellness questionnaires are helping improve communication and identify issues earlier.
Estelle Hodges, Ward Manager on the Coronary Care Unit said:
“We were one of the initial pilot wards and have had some really positive feedback to the wellness questionnaires, patients are clearer about their management plan, which is designed to get them well and back in their own homes. They are a couple of really simple questions, but they often spark a bigger conversation.”
Jon Sturman, Consultant Anaesthetist at NCIC said:
“Call for Concern gives a voice to patients and their loved ones, we know families know their loved ones better than anyone, they can spot when
something isn’t right in ways that even experienced doctors might miss. It’s ultimately another method of escalation, where concerns are highlighted and responded to, which can only make the care we provide safer for everyone.”
Call for concern is now in operation for any serious concerns patients or families may have, in the first instance patients and families should speak to the nurse or doctor in charge of their care, for other non-urgent or clinical issues the PALS team are on hand to support.