Call for concern – a patient safety initiative
Imperial College Healthcare NHS Trust has extended its roll out of the 24/7 service that helps patients, relatives and carers get direct access to senior clinicians if they are concerned that ward staff aren’t recognising that a patient’s condition may be getting worse.Clinical deterioration is detected by clinical staff every day, using their own skills and knowledge as well as digital and other early warning systems. However, friends and relatives, as well as patients themselves, may spot ‘soft signs’ of deterioration before it becomes apparent to staff.
The initiative, Call for concern, enables patients and families to call our response team at any time of day with their worries. The service is for patients who are staying in our hospitals. The response team, who already work closely with colleagues across our hospitals when a patient is very unwell, will assess the situation and take any action that’s needed.
Since early 2024, the service has received 196 calls, with 88 requiring clinical review. These calls have led to interventions such as bedside nursing support, pain management, and oxygen therapy, with no patients requiring transfer to higher-level support such as intensive care. For non-urgent calls, people have been directed to other services and encouraged to speak to the health care team supporting them or their loved one.
To ensure that everyone is aware of this service, we are installing stickers next to our hospital beds. These have been developed with patients, our patient safety partners and lay members. Volunteers from Imperial Health Charity are installing these at every adult and children’s bed in Charing Cross, Hammersmith, St Mary's, and Queen Charlotte & Chelsea hospitals.
Call for concern is part of Martha’s Rule – a national patient safety initiative providing patients and families with a way to seek an urgent review if their or their loved one’s condition deteriorates and they are concerned this is not being responded to. We are taking part in the national pilot to see how this can be implemented successfully in our hospitals.
The scheme is named after Martha Mills, who died from sepsis aged 13 in 2021, after King’s College Hospital failed to escalate her to intensive care and did not respond to her family’s concerns. Similar incidents are seen in hospitals across the country and are not isolated to one organisation.
Professor Raymond Anakwe, medical director at the Trust, said: “It is great to see the wider roll out of our Call for concern service, which we have seen provide an extra safety net to our patients over the last year.
“We are committed to continuing to deliver the highest level of care and hope that this service continues to provide additional reassurance and empower patients and their loved ones to raise any concerns they may have.”
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