Martha’s Rule—detecting deterioration

Are you concerned about a patient’s condition? We are here to help.

We want all patients and families to feel safe speaking up when they’re worried.

Sometimes, you may notice a change before we do—and that can be critical.

If you’re concerned that a patient’s condition is getting worse and the ward team hasn’t recognised or acted on it, you can call our dedicated response team directly. This service is available at Chelsea and Westminster Hospital and West Middlesex University Hospital.

Call 020 3315 4044. The service is open 24 hours a day, 7 days a week.

When to use the service

You can use the service if:

• If you are a patient and feel your condition is worsening
• If you are a relative, friend or carer concerned about a patient’s condition
• If a patient’s condition has changed and you feel the ward team hasn’t addressed it
• If you have ongoing concerns after you have spoken to the ward nurse or doctor

Note: This service is for urgent clinical concerns. For non-medical issues such as food, parking or your room, please speak to your nurse, ward manager or contact PALS.

What to do if you're worried

• First, speak to the team caring for you or your loved one
• If, after speaking to the care team, you remain worried and feel your concerns are not being addressed, call for a rapid review

Calling this service will never negatively affect a patient’s treatment. No one knows your health care needs or those of your loved one, better than you and your family.

When you call, you’ll be asked:

• Which hospital are you calling from (Chelsea or West Middlesex)?
• Who are you concerned about?
• What are you most concerned about right now?
• Are there any healthcare staff on the ward who can assist until we arrive?

The response team, who already work closely with hospital colleagues when a patient is very unwell, will discuss the concern and assess the patient if necessary.

You can call at any time. If you don’t get through, leave your name, the patient’s name and your number. The team will call back as soon as possible.

Our commitment

We will regularly ask for your views and take your concerns seriously. We see you as a partner in the care we are providing and want you to raise any worries and concerns you may have.

Difference between Martha’s Rule and second opinion

Martha’s Rule allows hospital inpatients and their families to seek a rapid review if their condition, or the condition of a loved one, is deteriorating.

A second opinion is when you would like to see another consultant to discuss any diagnosis or treatment.

More information about Martha’s Rule

This service is part of Martha’s Rule—a national patient safety initiative that gives patients and families a clearer, faster way to raise serious concerns.

We’ve been offering this service at our Trust since 2024.