Martha’s Rule: Detecting Deterioration

Are you worried your, or your loved one’s physical condition is getting worse?

This patient information leaflet provides information that may help you or your relative during their stay in our hospitals.

United Lincolnshire Teaching Hospitals NHS Trust strives to provide safe and high-quality care for all our patients, particularly to those who are at high risk of deterioration.

 

What is Martha’s Rule – Call for Concern?

We have introduced Martha’s Rule to help spot any unexpected signs of physical deterioration early. Call for Concern gives you the right to request a review if you are worried that you or your loved one’s physical condition is getting worse and is not being adequately recognised by the ward teams. You may notice small changes before they show up in our routine measurements, and 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, the same or worse. This is to monitor any unexpected changes in their condition and provides an opportunity to discuss the patients plan of care.

Your role is vital:

To help us detect the early signs of unexpected deterioration, please tell us if you are worried about:

• Worsening pain
• Levels of hydration
• Any changes to the skin (e.g. rash)
• Changes in breathing
• Low energy, drowsy, or sleepy
• New confusion
• Changes in temperature – hot or cold to touch
• Anything that does not feel right

Telling our ward staff about any of these changes can help us detect physical deterioration early so we can take action to prevent more serious health problems.

When to contact Call for Concern:

If you are concerned that you or a loved one’s physical condition is unexpectedly deteriorating, first speak to the ward team about your concerns.

• If your concerns are not resolved, ask to speak to the nurse in charge on the ward
• If, after speaking to the ward team, you remain worried and feel your concerns about an unexpected deterioration are not being addressed, contact Call for Concern. Ask any member of staff how to do this or look out for our Call for Concern posters which contain the phone number for each hospital site.

Your call will be triaged by a different team in our hospitals who will ensure that when needed, you or your loved one is seen by a healthcare professional who specialises in the care of deteriorating patients. Call for Concern is available 24 hours a day seven days a week, providing an independent assessment and treatment if needed. They will work with you and the ward team in addressing your concern.

How to contact Call for Concern:

Call us directly on our dedicated mobile phone or leave us a message and one of our team will call you back as soon as they are available.

Please be aware that we cannot guarantee a specific call back time as the responder may be reviewing other clinically unwell patients.

• Lincoln County Hospital – 07393 009049
• Pilgrim Hospital, Boston – 07761 053863
• Grantham & District Hospital – 07393 009033

What we need to know when you call us:

• The name of the patient you are concerned about
• The ward they are currently staying on
• A brief description of your concerns

Please ensure you discuss any concerns with the ward teams prior to calling the team.

Please do not feel worried that using Call for Concern will negatively impact your, or your loved ones, care in any way.

You do not need to contact the Call for Concerns service:

To report any issues that would be regarded as a complaint or relate to your hospital stay including communication, plans of care or any other general concerns, please speak with the ward nurse or ward sister/charge nurse. You can also request to have the contact details for the Divisional Matron to discuss any issues further if needed.

More information and support:

PALS is a free and confidential service that can provide patients, relatives and carer’s independent help, support and information.

PALS can also be used to comment on any aspect of your care; they will liaise with staff and managers to address issues quickly. They can also refer you to specialist agencies for further help.

Patient Advice and Liaison Service (PALS)

Lincoln – 01522 707071

Boston – 01205 446243

Opening hours: Monday to Friday, 9am to 3pm

Out of hours, please leave a message on the answerphone.

Find out more about the PALS service on the United Lincolnshire Teaching Hospitals NHS Trust website: www.ulh.nhs.uk/patients/pals

For more details on Martha’s Rule from NHS England, please scan the QR code below:

References

Martha’s Rule –  Information for patients, families and carers

Martha’s Rule –  NHS England website – Martha’s Rule

Patient Information Leaflet adapted from NHSE Marthas Rule Communications Toolkit