My loved one is getting worse in hospital and no one is listening
In NHS hospitals in England, patients and families can ask for an urgent review by a different clinical team if they're worried someone is getting worse.
The interactive version is available in 6 languages and Easy Read.
Your rights
- To ask for a rapid review from a critical care outreach team (Martha's Rule).
- To have your concerns about deterioration recorded.
- To be involved in decisions about care, as far as the patient wants.
What to do next
- Ask any staff member first. If that doesn't work, use the Martha's Rule / Call for Concern number shown on the ward.
- Say clearly what has changed: breathing, confusion, pain, eating, or 'this isn't like them'.
- Write down the time you raised it and who you spoke to.
Say this
“I'm worried they are getting worse. I'm asking for an urgent review under Martha's Rule.”
The law behind it (England)
- Martha's Rule (NHS England)rapid review on request
- NHS Constitution for Englandright to be involved in care decisions
Elsewhere in the UK
- Scotland
- In Scotland, ask the nurse in charge for an urgent senior review. Some boards run similar escalation schemes.
- Wales
- In Wales, a version of Martha's Rule is being rolled out across health boards. Ask the ward.
- Northern Ireland
- In Northern Ireland, ask for the nurse in charge and an urgent senior review.
Easy Read
What you need to know
- You think someone in hospital is getting worse.
- Staff are not listening to you.
- In England, you can ask for an urgent check by a different team. This is called Martha’s Rule.
What you can do
- Tell a nurse first.
- If nothing happens, call the Martha’s Rule number on the ward.
- Write down the time and who you spoke to.
Last reviewed: November 2026. This is general information, not legal advice. How we check our information.