‘Landmark’ safety policy was barely tested before launch

The “Martha’s Rule for maternity services” was used just 13 times in a national pilot before being cited by government and adopted by ministers as a solution to the maternity crisis, HSJ can reveal.

The finding has prompted a health leader to warn the policy risks becoming a “sticking plaster” that distracts from “deeper consideration of issues with working culture”.

Following Donna Ockenden’s damning investigation into Nottingham University Hospitals Trust, the Department of Health and Social Care pledged to extend Martha’s Rule – which guarantees an urgent, independent review of care – into every English maternity service.

DHSC described it as a “landmark patient safety measure” that would mean “mothers and newborns across the country will be better protected”. 

However, HSJ has learned that a seven-month pilot run by NHSE to assess its effectiveness across 15 maternity units recorded just 13 calls for a review between July 2025 and February 2026.

NHS England, which ran the pilot, stressed that its objective “was not to assess whether to roll it out to maternity units, but how it could be used most effectively alongside existing safety protocols”.

However, Nuffield Trust chief executive Thea Stein told HSJ  the  FOI data “casts further doubt on how transformative this new policy can really be”. 

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HSJ, 9 September 2026