England has introduced a new rule that gives families a formal channel to raise concerns about the care of a relative in an A&E department. The rule, known as ‘Martha’s Rule’, requires a senior clinician or nurse to acknowledge a family complaint within ten minutes and to put it on the patient’s record.

The decision follows a high‑profile case in which 13‑year‑old Martha Mills died after her family’s repeated requests for a review of her treatment went unanswered. The government says the rule will reduce the risk of similar failures and restore trust in emergency care.

"Families must feel they can speak up without fear of dismissal," said a senior NHS spokesperson.

The rule was drafted by the Department of Health and Social Care after a review of A&E incidents that highlighted a systemic failure to listen to families. According to the BBC, the policy will be rolled out across the 140 acute hospital sites in England by the end of the year, with training programmes for staff beginning next month.

Under the new regulation, if a family member raises a concern, the attending clinician must record the issue, explain the next steps, and offer a follow‑up appointment. If the concern is not addressed within seven days, the patient safety officer will be notified automatically.

The policy is part of a broader NHS strategy to improve patient safety after a series of high‑profile complaints. A 2024 audit found that only 36 % of families reported that their concerns were taken seriously in the emergency department. The new rule aims to raise that figure to 90 % by 2028, the department’s target.

Critics argue that the rule could add pressure on already stretched staff and create a litigious environment. A senior nurse in a London teaching hospital said: “We need support and clear guidance; otherwise, it could become a bureaucratic hurdle.” The NHS has pledged to provide additional staffing and digital tools to help teams meet the new deadlines.

In the short term, the rule will be monitored through a quarterly audit of A&E complaints and patient outcomes. The first review is scheduled for March next year, and the findings will be published in the NHS Digital patient safety bulletin.

The introduction of Martha’s Rule follows a wider push to give patients and families a voice across the health system, including the rollout of specialist courts for rape cases that will allow victims to view proceedings remotely. The government says these reforms will strengthen the public’s confidence in the NHS and help prevent avoidable harm.

For patients, the rule means that a family can raise a concern about anything from delayed treatment to inadequate communication, and have that concern formally documented. The policy also obliges hospitals to maintain a public register of complaints and resolutions, which will be accessible online.

With the rule now in force, the NHS aims to close a gap that has persisted for years. If the policy succeeds, it could become a model for other countries looking to improve safety in emergency care. The next step will be to assess the rule’s impact on outcomes such as treatment delays, infection rates and patient satisfaction.

The rollout of Martha’s Rule marks a significant shift in how the NHS addresses family concerns, signalling a move toward greater accountability and transparency in hospital care.