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What is Martha’s Rule under the strengthened NHS guidance?


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Martha’s rule gives special preference to same-sex and transgender patients to request same sex wards and staff under the government’s newly proposed NHS guidance

The Department of Health and Social Care (DHSC), led by Victoria Atkins MP and Maria Caulfield MP, has unveiled proposed updates to the NHS Constitution for England, aiming to fortify the principles of privacy, dignity, and safety for all patients.

Martha’s rule was prompted by a campaign led by the parents of 13-year-old Martha Mills who tragically succumbed to sepsis after staff at King’s College Hospital failed to escalate her care to intensive care, despite her family’s pleas regarding her worsening condition in 2021.

Under the new guidance is the introduction of Martha’s Rule, empowering patients to request intimate care from someone of the same biological sex ensuring that the distinct needs of men and women are recognized and addressed.

Patients and their loved ones can exercise the right to “access to a rapid review from outside the care team if the patient is deteriorating.”

The consultation on the proposed updates is set to run for eight weeks, inviting feedback from patients, healthcare professionals, and stakeholders for a review

This provision for single-sex wards aligns with the Equality Act 2010 which acknowledges the rights of transgender patients.

Health and Social Care Secretary Victoria Atkins emphasised the importance of respecting patients’ preferences for same-sex care, stating that the NHS should strive to accommodate such requests wherever possible.

She said: “By putting this in the NHS Constitution we’re highlighting the importance of balancing the rights and needs of all patients to make a healthcare system that is faster, simpler and fairer for all.”

Minister for Women’s Health Strategy Maria Caulfield highlighted the significance of updating the NHS Constitution stating:

“This is about putting patients first, giving them the dignity and respect that they deserve when they are at their most vulnerable.”

“Our plans include accommodating requests for same-sex intimate care and respecting single sex wards,” she added.

Louise Ansari, Chief Executive of Healthwatch England, welcomed the proposed updates, highlighting the NHS Constitution’s role in empowering patients and shifting the balance of power towards them and their families.

However, she stressed the need for greater awareness of patients’ rights, urging the public to participate in the consultation process to ensure that their voices are heard.

“Rights on paper are worthless unless they are delivered in practice,” says Wes Streeting

Responding to proposed changes to the NHS Constitution by the Government, Wes Streeting, Shadow Health Secretary, emphasised the importance of translating rights into practical implementation.

“The NHS constitution already pledges that no patient will have to share an overnight ward with patients of the opposite sex, but that is not the case for too many patients.”

Streeting expressed alarm over the rising use of mixed-sex wards, noting:

“Women were forced to spend the night on wards alongside male patients 44,000 times last year, twenty times as many as a decade ago.”

He emphasized the significant risk to patients’ safety posed by this trend.

Streeting attributed the situation to Conservative cuts to hospital beds and a failure to train sufficient staff, which he argued has left the health service unable to safeguard patients’ basic dignity.



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