Martha’s Rule Programme data collection

Martha Mills died in 2021 after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling off her bike. 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.

In response to this and other cases related to the management of clinical deterioration, the then Secretary of State for Health and Social Care and NHS England committed to implement Martha’s Rule across the NHS.

Martha’s Rule is a patient safety initiative to support the early detection of deterioration by ensuring the concerns of patients, families, carers and staff are listened to and acted upon.

Martha’s Rule includes the implementation of all 3 components being available in an organisation, in both adult and children and young people settings:

Find out more about Martha’s story and Martha’s Rule.

The Martha’s Rule Programme is led by the National Director of Patient Safety in NHS England. The implementation is being led and facilitated by the National Patient Safety team in partnership with the National Nursing Directorate.

The aggregate data collection was launched to support learning and assess the impact of the programme. Phase 1 sites began reporting data in October 2024 and Phase 2 sites began reporting in September 2025.

Martha’s Rule Programme data collection aligns with existing statutory duties of NHS England under the Health and Social Care Act 2012 (and the NHS Act 2006):

• Section 13R, NHS Act 2006: NHS England must, in exercising its functions, promote research on matters relevant to the health service, and the use in the health service of evidence obtained from research. While not directly research, Martha’s Rule’s emphasis on data collection, monitoring, evaluation, and evidence-based iteration supports that function of promoting and using evidence
• Section 13E, NHS Act 2006: NHS England must “secure continuous improvements in the quality of services … including the outcomes from those services.” Martha’s Rule is squarely a quality-of-care and patient safety intervention, seeking to reduce harm and improve clinical outcomes

NHS acute hospitals across England are required to submit data at site-level on a monthly basis for the previous months’ activity.

Registered data submitters of the data collection will receive monthly emails from Strategic Data Collection Service (SDCS) confirming when the reporting window is opening and closing.

A report is published each month which provides an analysis of submissions to the Martha’s Rule Data Collection. This data relates to phase 1 and phase 2 sites within NHS acute hospitals across England. This data has been published as management information on the NHS England website.

Your feedback on the format, frequency and utility of these reports should be directed to [email protected].

If you have any queries regarding the Martha’s Rule Programme, please contact [email protected].

Further information about the data collection, including support materials can be found on Martha's Rule - National Deterioration Forum - Futures. You will need an NHS Futures account and to request access to view this page.  

Technical issues and questions relating to using the Strategic Data Collection System (SDCS) portal should be directed to the National Service Desk at [email protected].

Access information and guidance on how to login, upload, submit your data on to SDCS.

Further information can be found in the Data Alliance Board's (DAB) list of approved standards and collections.