West Hertfordshire Teaching Hospitals NHS Trust has introduced the Patient Wellness Questionnaire (PWQ) as part of the rollout of the Martha’s Rule patient safety initiative.
This means patients, families, and carers now have a clear, structured way to be actively involved in care.
The Trust is one of the first 143 pilot hospitals selected to implement Martha's Rule, making it an early adopter helping to shape how the PWQ is used across the NHS.
Louise Bradbury, Advanced Practitioner, Acute Care Response Team Lead, West Hertfordshire Teaching Hospitals NHS Trust, said:
“We want patients, families, and carers to feel confident that if something doesn’t feel right, there is a clear way to raise their concerns. They are often the first to notice subtle changes in a patient’s condition, and the PWQ, gives them a structured way to be involved. West Herts is committed to listening, supporting families, and providing safe, high-quality care. As an early adopter of Martha’s Rule, we’re helping shape national practice while keeping patient experience and safety at the heart of everything we do.”
The PWQ asks hospital inpatients two simple questions each day: “How are you feeling today?” and “How do you feel your progress is going?” Responses are recorded in the electronic patient record and generate a score, which is then acted upon in a structured way. This structured approach allows patients, families, and staff to raise concerns, including subtle changes not yet reflected in clinical monitoring.
Early results from West Herts pilot wards show the PWQ is already helping staff spot important concerns. High scores often highlight issues such as pain, difficulty sleeping, emotional distress, or subtle changes in a patient’s condition.
Martha’s Rule was introduced nationally following tragic cases, including that of Martha Mills in 2021. Martha, a paediatric patient, died from sepsis after a pancreatic injury. Concerns raised by her family about her deteriorating condition were not acted upon promptly. A 2023 coroner’s report concluded that Martha would likely have survived had she been reviewed and moved to intensive care sooner.
In response, the Secretary of State for Health and Social Care and NHS England committed to implementing Martha’s Rule. The programme ensures that patients, families, and carers can have their concerns heard and acted upon, helping prevent deterioration and improve safety across all inpatient settings.