In response to the tragic death of 13-year-old Martha Mills in 2021, County Durham and Darlington NHS Foundation Trust (CDDFT) has introduced Martha’s Rule, with the Call 4 Concern Service aiming to provide patients and their families with quicker access to expert clinical reviews when there are concerns about patient deterioration.
Melissa Todd and Gemma Nelson have been appointed as Martha’s Rule Implementation Lead Nurses at CDDFT, overseeing the Trust’s Call 4 Concern service, modelled on Royal Berkshire and introduced in March 2021.
The Call 4 Concern service allows patients, families, and carers to request rapid intervention and review from the Acute Intervention Team, offering 24/7 support at the Trust’s main hospitals.
CDDFT was the first Trust in the region and second nationally to provide this service.
Since the service was introduced the team has received 135 calls to date and feedback from patients and relatives has been positive.
“Loved ones will also spot sooner than anyone else if the patient is unusually confused or has deteriorated – perhaps there are some tell-tale signs in the way they look or behave. They know the patient inside out.”
Gemma added that the Call 4 Concern service isn’t about criticising ward staff but about providing a fresh, specialist perspective: “The acute intervention team attends promptly and is able to focus their specialist skills on that one patient. Not only does this patient then receive the care they need, but ward staff can continue focusing on the many other poorly patients they’re looking after.”
Call 4 Concern posters are displayed across all wards and departments across our hospital sites with contact information for The Acute Intervention Team’s Nurse Practitioners who are available 24/7 and are highly skilled in assessing deteriorating patients. They also form part of the emergency team, providing knowledge and support to staff caring for patients of all ages who are clinically deteriorating or may be in the last days or hours of their life.
The Call 4 Concern service complements the national rollout of Martha’s Rule, named after Martha Mills, who passed away after developing sepsis in 2021. A 2023 coroner’s report concluded that Martha could have survived if her family’s concerns about her condition had been acted upon earlier.
By giving families the ability to raise concerns directly and access rapid expert reviews, CDDFT is demonstrating its commitment to safe, compassionate, joined-up care and ensuring that critical signs of deterioration are promptly addressed.
