Summative evaluation of Martha's Rule - Qualitative WP (MARSEQ Study)
Research type
Research Study
Full title
Martha’s Rule Summative Evaluation: Qualitative Work Package (MARSEQ Study); Understanding the implementation, consequences and impact of a national initiative to listen to and act on patients, families, carers and staff concerns about acute illness and deterioration – using qualitative approaches
IRAS ID
367006
Contact name
Rebecca Lawton
Contact email
Sponsor organisation
Braford Teaching Hospitals NHS Foundation Trust (BTHFT)
Duration of Study in the UK
2 years, 5 months, 31 days
Research summary
Martha’s Rule is a national patient safety initiative designed to ensure that patients, families and staff have a clearly signposted and accessible route to request a rapid independent clinical review when they are concerned a patient is deteriorating and feel their concerns not being fully addressed by the local care team. Martha’s Rule was introduced in 2024 to 143 pilot sites and has since been rolled out to all NHS adult/paediatric acute inpatient services with full implementation expected to be complete by 2026/27.
This evaluation will offer a national understanding of the implementation of Marthas rule, including how it has impacted staff and patients, how deterioration is managed in practice, what has helped and hindered its implementation, how it impacts inequalities, and its contribution towards fostering cultural change. The evaluation will take place at 16 NHS Trusts across five regions, and will involve 1) focused and structured observations at each ward and critical care outreach (CCO) teams, and 2) interviews with senior implementation leads, CCO team members, and ward staff and 3) interviews with patients and family members from participating wards or those who have escalated concerns. The Safety arm of the NIHR Policy Research Unit carried out an initial evaluation of Martha’s Rule during its first year of implementation, and this work will build on this by understanding implementation and impact at a national scale at 2-3 years post-implementationWe will also distribute a survey to the general public (through YouGov and Care Opinion) to understand the general public’s awareness and perspectives of Martha’s Rule.
We will work with key stakeholders to disseminate findings to the general public, patients and carers, and to develop recommendations for policy makers and organisations to support the wider implementation of Martha’s Rule. This work will be carried out by all six NIHR Patient Safety Research Collaborations in the UK.
REC name
Yorkshire & The Humber - Leeds West Research Ethics Committee
REC reference
26/YH/0067
Date of REC Opinion
17 Apr 2026
REC opinion
Favourable Opinion