Families at the Countess of Chester Hospital are making early use of a new rapid-review hotline under Martha's Rule, as local figures reveal strong uptake of the service in Chester.

Martha's Rule is a national safety scheme that lets patients and families request an urgent review if they feel a condition is getting worse and concerns have not been recognised. 

It was introduced after the death of 13-year-old Martha Mills, who died from sepsis in 2021 after her family's warnings about her deterioration were not acted on.

The scheme is designed to ensure patients, relatives and staff can all escalate concerns quickly, recognising that those closest to a patient are often the first to notice when something is wrong. 

National figures released in the past month suggest it may already have contributed to more than 400 lives being saved across England.

Locally, the hospital has published new data showing that patients and families in Chester are using its own escalation route at similar levels to the national picture, helping raise concerns early and request prompt clinical reviews.

"What matters most is that people are calling us when they are worried," said Andrea Reynolds, lead nurse for the Critical Care Outreach team at the Countess of Chester Hospital.

"When they do, the outreach team responds - that's exactly how the system is designed to work. Sometimes the review simply offers reassurance, but in other cases it allows us to assess someone whose condition may be changing. 

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"Acting early can make a real difference."

At the Countess of Chester Hospital, Martha's Rule is delivered through "Call 4 Concern", allowing patients and families to contact a specialist team directly if something isn't right.

Rolled out hospital-wide in April 2025 after a pilot, it has since been used 107 times, with 36% of calls leading to a rapid assessment.

The pilot phase beforehand showed similar levels of engagement, with 33 calls in its first year and 21% leading to a rapid review, suggesting patients, families and staff were confident using the system from the outset.

Since April 2024, calls have come from a wide range of inpatient areas - some triggered by sudden changes in a patient's condition, others by families who felt something wasn't right. Staff say this shows speaking up early is becoming routine, with families increasingly confident in raising concerns.

The patterns seen in Chester are similar to those reported nationally.

NHS England's figures for September 2024 to December 2025 show more than 10,000 calls to Martha's Rule helplines, with around one third (34%) prompting urgent clinical review. 

"National evidence shows that families often notice the earliest signs that something isn't right," said Dr Nigel Scawn, executive medical director at the Countess of Chester Hospital NHS Foundation Trust.

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"Having a clear, well‑publicised route to raise concerns is an important part of keeping patients safe and in some cases saving lives. 

"If you are worried, we want to hear from you. Families play a vital role in recognising early changes and Call 4 Concern ensures their voices are heard." 

Patients and families are given information on arrival to help them understand how to request a review, and further details are available on the hospital website.