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Martha’s Rule: Detecting Deterioration
You know yourself or your loved one better than anyone. If you’re worried about a health condition getting worse, talk to us.
What is Martha’s Rule?
We have introduced Martha’s Rule to help spot any unexpected signs of deterioration early and give you the right to request a rapid review if you’re worried that your or your loved one’s condition is getting worse.
You may notice small changes before they show up in our routine measurements. These changes could be early warning signs of deterioration.
How we monitor patients
While someone is in hospital, we regularly check their vital signs and other important health measurements. The frequency of these checks will depend on the patient’s individual condition and needs. Sometimes we may need to wake patients to do these checks.
In addition, we will ask at least daily if they are feeling better or worse. This is to monitor any unexpected changes in their condition.
Your role is vital
To help us detect the early signs of deterioration, please tell us if you are worried about:
Changes in temperature – hot or cold to the touch
- Worsening pain
- Any changes to the skin (e.g. rash)
- Low energy, drowsy or sleepy
- Levels of hydration
- Changes in breathing
- New confusion
- Anything else that worries you
Telling our staff about these changes can help us to detect deterioration early so we can take action to prevent more serious health problems.
Standard ward practice
Please follow the steps below if you are concerned a patient’s condition may be getting worse.
Step 1: If you are worried that you or your loved one may be getting worse in hospital, tell your named nurse or doctor.
Step 2: You can also speak to the nurse in charge or ward manager if you feel your concerns have not been addressed.
Ward teams are experts in the care of their patients and complications of illness but will refer patients to Critical Care Outreach and other services for review when needed.
What to do if you’re still worried
If, after speaking to the care team, you remain worried and feel your concerns are not being addressed, call for a rapid review.
Contact us
Royal Sussex County Hospital (Brighton & Hove)
07917 836543
Princess Royal Hospital (Haywards Heath)
07747 201999
Worthing Hospital (Worthing)
07788 878656
St Richards Hospital (Chichester)
07710 978715
Your call will go to a different team in our hospital, who specialise in the care of critically ill patients. They will work with you and your care team to arrange any treatment needed or further review.
The service is available 24 hours a day, seven days a week. Please note the team may not be able to answer your call immediately if they are responding to an emergency within the hospital.
The difference between Martha’s Rule and a second opinion
Martha’s Rule gives hospital patients and their families direct access to an independent assessment if their condition is getting worse.
A second opinion is an already established process where patients and their families can ask to see a different consultant to discuss a diagnosis or treatment. This can take time to arrange. If you would like a second opinion, you can raise this with your current consultant yourself or discuss your concerns with the ward manager.
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.