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Martha's Rule and Call for Concern© at UHS

Martha’s Rule is a patient safety initiative that was set up after the preventable death of 13-year-old Martha Mills.

There are three aims of Martha’s Rule:

1. Asking patients daily how they’re feeling

Patients will be asked, at least once a day, whether they feel better, worse, or about the same. Any noted change should be acted on in a structured way.

The way in which we do this for patients will sound different depending where in the hospital you are. In the adult area of the hospital, we are currently piloting how best to achieve this aim. In paediatrics and neo-natal, this is already built into the observation system. Maternity will have this question built into their new IT system in 2026.

2. Staff escalation

Any staff (nurse, midwife, doctor, allied health) can, at any time, request a review from a different team if they believe a patient is deteriorating and isn’t being responded to appropriately.

There are processes in place for staff to request a rapid review from a different team if they are concerned their patient is becoming more unwell.

3. Patient, family or carer escalation

If a patient, relative, or carer is worried after speaking to the ward team, they can trigger a Martha’s Rule (Call for Concern) review by calling a dedicated number advertised in the hospital.

What is Call for Concern?

Call for Concern (C4C) is an inpatient safety service and is part of Martha’s Rule. It gives inpatients or their loved ones an opportunity to call for help a when they feel concerned that the health care team has not recognised their own or their loved ones worsening condition.

Call for Concern is delivered by a team of healthcare professionals who are available 24 hours a day.

When to make a Call for Concern call

Phone the Call for Concern service if:

  • The patient is becoming more unwell, and you have spoken to midwives, nurses or doctors looking after the patient, but you’re still worried about the patient’s health.

Contact us by calling the number at the bottom of the page.

When not to make a Call for Concern call

  • If you have a problem regarding the hospital bed, room, talking with the medical team, food, parking, or any other general issue please speak to a member of the ward team and ask for the nurse/ midwife in charge.

  • You can ask to speak to the ward matron to discuss any further issues.

Responding to your call

When you make the call, the person answering they will need to know:

  • Your name (if you are the patient) or the name of the patient you are concerned about.
  • In which area of hospital the patient is located, for example, the patient is a child in the Children’s Hospital on G3. Or, the patient is in Princess Anne Hospital on labour ward.

This will enable them to direct your call to the correct Call for Concern team.

What happens next:

The Call for Concern team will then need to know

  • The patient's name
  • The patient’s specific location, for example, D6, or Bramshaw ward
  • A brief description of the concern

If the worry is about the patient becoming more unwell, then the C4C team will come and check their condition and decide how best to help the patient. If your worry is about something else, you will be put in touch with the right person to help you.

Someone from the C4C team will then contact you to check that your concerns have been addressed, and that you or your loved one has received the appropriate treatment, if needed.

Please note that the C4C team will aim attend to you or your loved one to resolve your concerns in a timely manner. However, depending on the demand for the service, there may be times when the team are delayed in visiting you. We thank you for your patience and understanding.

A concern is not complaint! Please do not feel concerned that using this system will negatively affect your or the patient’s care in any way. We recognise that sometimes patients, relatives or carers can see that something is wrong before we can. No one knows your or your loved one’s health care needs better than you and your family.

Contact us

Call 023 8077 7222 – ask for the Call for Concern service. This number is only for patients in University Hospital Southampton NHS Foundation Trust hospitals.

Feedback is always welcome!

For any questions or feedback please email emma.bailey2@uhs.nhs.uk 

The Call 4 Concern copyright is owned by Royal Berkshire NHS Foundation Trust and used with their kind permission.