Patients who believe their concerns are not being taken seriously by medical staff should be given the right to seek an urgent second opinion, the parents of a girl who died of sepsis, and the thinktank Demos, have said. Martha Mills, who would have been 16 on Monday, died aged 13 in 2021 after failures to identify and properly treat a case of sepsis that developed while she was in King’s College hospital in London.
In 2022, a coroner ruled that Martha would have survived had doctors identified the warning signs and transferred her to intensive care earlier. Martha suffered a laceration to her pancreas in what initially appeared to be a minor accident while cycling. She was transferred to the hospital in south London because it is one of three national centres for the care of children with pancreatic trauma. Her condition was not thought to be life-threatening. She developed sepsis, though that too could have been treated. Her parents said their concerns that her health was deteriorating were not heeded, with doctors instead trying to reassure them – even as Martha’s condition worsened and nursing staff privately acknowledged she was at risk of death. “Even if you were to give the doctors the benefit of the doubt and say they were trying not to worry us, the result is that they did not give us any agency in demanding the correct treatment for our daughter – and that control, that overconfidence in yourself and your decision making – is absolutely fine if the system works perfectly, but the system is so far from perfect,” said Martha’s mother, Merope Mills, a senior editor at the Guardian. She has helped the thinktank Demos write a report calling on NHS England to urgently put in place “Martha’s rule”, which she said would “effectively formalise the idea of asking for a second opinion, from a different team outside the team currently looking after you if you feel you are not being listened to”. Several opportunities to seek a critical care review, which the coroner found could have helped save Martha’s life, were missed and a report found doctors on the unit where the teenager received the majority of her care had “sometimes questioned the value of review”.
Merope Mills told the BBC that parents instigating the process themselves “shouldn’t be a problem and it shouldn’t involve confrontation” – and that such systems already existed in other health services around the world. She told Radio 4’s Today programme that she had heard doctors whispering outside her cubicle after seeing her daughter, and tried to hear what was being said – later asking herself why parents could not have been included in those conversations. “I genuinely believe that good doctors should welcome good input from patients or family members – who are the other experts in the room – and they should certainly welcome the input and second opinion of another doctor.” The Demos report said NHS England should introduce a system allowing parents to easily call for a second opinion. It said it could be modelled on the Call 4 Concern system that has already been adopted in several UK hospitals – as well as on Australia’s “Ryan’s Rule”, which helps parents and carers alert doctors to a patient’s worsening condition. “These schemes give patients a direct line to ask a separate clinical team to request a review, or a second opinion. Research in hospitals that have adopted it have found that it improves treatment in lifesaving ways and is rarely abused. It requires thoughtful implementation but has proved manageable and effective.” An NHS spokesperson told the BBC: “All patients and families are able to seek a second opinion if they have concerns about their care and, as professional guidance for doctors in England sets out, it is essential that any patient’s wishes to seek a second opinion are respected.”