Martha’s Rule and Managing Deterioration

The aim of this programme is to reduce deterioration-associated harm. To achieve this, it is essential to have safe and reliable pathways of care. By 2027, as a result of enhanced system coordination our work will have improved the prevention, identification, escalation and response (PIER) to physical deterioration across the partners we work with. 

There are two elements to this programme: 

1. The introduction of Martha’s Rule  
2. Working with systems to use the PIER improvement toolkit to design and implement a managing deterioration improvement plan.  

Martha’s Rule

The first phase of the introduction of Martha’s Rule is piloting and implementing it in at least 100 NHS hospital sites nationally from April 2024. Once fully implemented, patients, families, carers and staff will have round-the-clock access to a rapid review from a separate care team if they are worried about a person’s condition. 

Our focused approach is to support the first phase provider sites in the East of England to test, implement and collate learning to inform the development of wider national policy proposals for Martha’s Rule that can be expanded across the NHS from 2025/26. 

Managing Deterioration

Alongside Martha’s Rule, we will support a wider approach to improve the management of deterioration using a suite of resources designed around PIER, which helps systems to prevent, identify, escalate and responds to physical deterioration.

Further information

For more information, please contact Amanda Farwell, Senior Improvement Lead, at amanda.farwell@healthinnovationeast.co.uk