Call for concern

When you call, you will be asked to pick your hospital site. This will put you through to the most appropriate person.

You will be asked:

• Where are you calling from and who are you concerned about?
• What are you most concerned about right now?
• Are there any other healthcare staff on the ward that can help you until I get to see you or the patient?
  

Call for concern should only be used after you have spoken to the nurse in charge or the doctor responsible for the patient’s care, and you still have concerns.

• If you are a patient and feel that your condition is deteriorating
• If you are a relative, friend or carer who has concerns about a hospital patient’s clinical condition deteriorating
• There has been a change in clinical condition and you feel the ward team aren’t addressing the concern.
  
  

Please speak to the ward team around any concerns you have, these can be clinical or non-clinical. Call for concern is only for clinical concerns.

If you have spoken to the ward team and still have concerns (that are not related to your clinical condition), you can contact our patient advice and liaison service (PALS).

The scheme is named after Martha Mills, who died from sepsis aged 13 in 2021 after King’s College Hospital, London, failed to escalate her to intensive care and did not respond to her family’s concerns. Similar incidents are seen in hospitals across the country and are not isolated to one organisation. 

Martha’s Rule is to be made up of three components to ensure concerns about deterioration can be swiftly responded to. 

Firstly, an escalation will be advertised throughout the hospitals on posters and leaflets, enabling patients and families to contact a critical care outreach team that can swiftly assess a case and escalate care if necessary. Secondly, NHS staff will also have access to this same process if they have concerns about a patient’s condition.  

At Imperial College Healthcare NHS Trust, these two components are already implemented. Call for concern is our escalation process for patients and families. 

Finally, alongside this, clinicians at participating hospitals will also formally record daily insights and information about a patient’s health directly from their families, ensuring any concerning changes in behaviour or condition noticed by the people who know the patient best are considered by staff. 

At the Trust, we are working with the Change Lab, from Imperial College, to develop and test methods of doing this.