Call 4 Concern

The patient safety initiative was developed in response to the death of Martha Mills who died in 2021 due to developing sepsis in hospital after she was admitted with a pancreatic injury following a fall from her bike. Martha’s family’s concerns about her deteriorating condition were not listened to, and in 2023 a coroner ruled that Martha, aged 13, would probably have survived had she been moved to intensive care earlier.

In response to this, and other cases related to the management of clinical deterioration, NHS England committed to implementing the system, also known as ‘Martha’s Rule’, across all hospital settings.

Central to the system is the right for patients, families and carers to request a rapid review if they are worried that they or their loved one’s condition is getting worse and their concerns are not being listened to.

Call 4 Concern (C4C) was initially launched by Medway Maritime Hospital in January 2023 for adult inpatients but has been rolled out across the two other services after the hospital was chosen as one of 143 hospitals in England to fully implement the system in both adult and children’s inpatient settings.

We recognise that sometimes patients, relatives and carers can tell when something is wrong.

You can use Call 4 Concern if:

• You are an inpatient, or a relative or a carer of an inpatient, and you have concerns about your/their clinical condition.
• You have noticed a change or decline in your/their clinical condition and you feel that the ward team have not addressed your concerns.

You should only call after you have spoken with the nurse in charge or doctor responsible for the patient.

When the Acute Response Team receive your Call 4 Concern call, they will need to know the patient’s name and the ward they are on, as well as brief description of the problem.

After prioritising the urgency of the problem, a member of the team will visit the patient on the ward to discuss your concerns and assess the situation.

A note of the C4C intervention will be logged in the patient’s notes summarising the concern raised and the actions taken.

Using this service will not have a negative impact on your care/the care of your loved one in any way.

Your call is important

There may be times when the C4C team cannot answer your call immediately, as the team may already be assessing another patient. In this instance, please wait for a short period and call the team back.