Hairmyres Hospital has become one of the first in Scotland to implement a new patient safety initiative inspired by Martha’s Rule.
The system is designed to ensure patients and their families can let senior hospital staff know if they feel a condition is worsening and concerns are not being appropriately addressed.
Martha’s Rule, introduced in hospitals across England over the past year, was developed in response to the tragic death of 13-year-old Martha Mills.
Despite signs her condition was deteriorating, Martha’s family felt their concerns weren’t being acted on, and a potentially life-saving second opinion was not sought. Her parents believe that if they had been able to trigger an urgent clinical review, her life might have been saved.
At Hairmyres, the initiative has been locally adapted into a service known as Call 4 Concern (C4C). Inspired by the C4C service run by the Royal Berkshire NHS Trust, It allows patients, families, or carers to directly contact a senior hospital clinician if they believe a patient is deteriorating and their concerns have not been resolved through usual care channels.
Dr Austin Rattray, Consultant in Anaesthesia and Intensive Care Medicine said: “Martha’s Rule highlights something many of us in healthcare already know – patients and families are often the first to notice when something isn’t right. With Call 4 Concern, we’ve created a safety net for those situations. It’s about listening, responding quickly and ensuring that everyone has access to a second opinion if they need it.
“We want patients and their families to know that their voice matters. C4C ensures there is a structured, responsive way to act when something feels wrong, no matter how small it may seem. It’s not about questioning care, it’s about partnership and vigilance – an extra layer of safety that puts patients first.”
The service is available 24/7 via a dedicated number – 01355 585300 – which connects callers to a senior member of nursing staff. This nurse coordinates a review and ensures concerns are actioned. Standard Operating Procedures have been developed to guide the response, with every C4C call tracked through the hospital’s daily handover process.
We encourage callers to follow a three step process. First speak to the patients healthcare team, then ask to speak to the nurse in charge, and then if they remain concerned, place a C4C call.
Staff are encouraged to support the initiative by raising awareness on wards, signposting patients and families to the C4C posters and leaflets, and reinforcing the message that asking for help is always the right thing to do.
The launch at Hairmyres is part of a wider patient safety focus across NHS Lanarkshire, and the plan is that the approach can be extended to other acute sites in future.
Chief of Nursing Services, Lise Axford added: “Ultimately, this is about creating another safety net for our patients, – and making sure we listen when loved ones raise concerns. Families, carers and patients should feel empowered to say, ‘I’m worried,’ and know that there is a clear process in place to act on that concern. That’s what Call 4 Concern is all about – putting patient voices at the heart of safety.”
For more information on Call 4 Concern, staff can access the full Standard Operating Procedure on FirstPort or contact Lise Axford or the Hospital Cover Team.
