IMPACT SNAPSHOT: Martha’s Rule/Patient Wellness Questions: Early Detection of Patient Deterioration

We co-developed a simple patient self-assessment tool that predicts deterioration 24 hours in advance, now adopted nationally as part of NHS England protocol.

#Sickness to Prevention
#Hospital to Community

Researchers created the “patient wellness questionnaire” – two 5-point scale questions asking patients how they feel and whether they’re better or worse than before. This gave patients a formal mechanism to report deterioration, replacing ad-hoc approaches where concerns were often dismissed.

Impact:
• Testing at Hull and Leeds hospitals demonstrated the questions could predict deterioration 24 hours in advance.
• The tool was adopted nationally as part of Martha’s Rule in May 2024, becoming stage 1 of the NHS England protocol.
• Now being implemented across all NHS trusts nationally.
• Evaluation commissioned by DHSC/NHSE involving all six NIHR PSRCs.

The tool’s simplicity meant staff could easily integrate it into routine care. NIHR infrastructure funding enabled the PhD research, provided access to patient groups and clinical networks, and facilitated collaboration with NHS England for national rollout. Without ARC funding, this life-saving innovation would not have been developed or scaled nationally.