Patient Safety Collaborative (GMECPSC) – Managing Deterioration

The National Patient Safety Improvement Programme (NatPatSIPs) three programmes of work collectively form the largest safety initiative in the history of the NHS. They support a culture of safety, continuous learning and sustainable improvement across the healthcare system.

The Care Home element of the national programme is led and co-delivered by the NHS England & Improvement patient safety team, who work with the 15 regionally based Patient Safety Collaboratives (PSCs). The national teams are closely aligned and supportive of the national enhancing health in care homes team.

In the first year of Martha’s Rule national pilot, 143 sites across England tested and implemented the three components of Martha’s Rule, identifying models that could be scaled up across the remaining providers. The first phase of the pilot ran until March 2025.

In April 2025, Phase 2 commenced, spreading Martha’s Rule to all remaining sites in England that provide adult and/or paediatric acute inpatient services. This involves sites who have a 24/7 Critical Care Outreach Team (CCOT), a partial CCOT service and those that utilise different models for escalation. In this phase, the programme will also be supporting a small number of sites to test and adapt the use of Martha’s Rule in maternity and neonatal, emergency departments, community hospitals and mental health settings.

NHS England » Martha’s Rule

In Greater Manchester  (GM)  6 hospital sites participatedin the national first phase Martha’s Rule pilot. HInM supported the identified phase one sites to implement Martha’s Rule. Working collaboratively with the local Paediatric Critical Care Operational Delivery Networks (PCC ODNs) and Adult Critical Care Operational Delivery Networks (ACC ODNs), the PSC supported provider teams using a systematic approach to test and scale up Martha’s Rule.

In the second phase of the Martha’s Rule pilot, HInM is working collaboratively with all 6 GM sites through a Community of Practice (CoP) model. This model creates a structure for organizations to easily learn from each other and from recognized experts in topic areas where they want to make improvements.”

The first CoP session is scheduled for 24^th July 2025, with further CoP sessions schedule to take place quarterly, until March 2026.

Through this model, HInM are working to bring together phase one sites and all relevant system stakeholders to:

• facilitate and nurture learning
• provide expertise and coaching in Quality Improvement (QI) methods
• provide a safe space to think, acting as a critical friend and mentor
• support site teams to use methodologies for sustaining change and improvement
• support teams to identify and understand the impact of Martha’s Rule using measurement methods.

In addition to the CoP sessions, HInM will offer Leadership Support sessions to Phase 1 sites and any GM Phase 2 sites that express an interest to participate, to provide ongoing support to pilot sites Martha’s Rule team leaders.