Publish date: 10 November 2025
We are raising awareness of our Call 4 Concern (C4C) patient safety service, which supports the principles of Martha’s Rule by empowering patients and their loved ones to speak up if they are worried about deterioration.
C4C enables inpatients, their families, friends, or carers to call for an urgent clinical review if they are concerned that a patient’s condition is getting worse and feel their concerns have not been fully acknowledged through the usual care discussions. The service is delivered by the our Critical Care Outreach Service (CCOS), which supports all areas of the hospital in caring for acutely unwell patients of all ages.
Matthew Reed, Advanced Clinical Practitioner and Team Leader for the Critical Care Outreach Service, said:
“At St Mary’s, we believe that Martha’s Rule and Call 4 Concern empower patients and families to speak up when they sense something is not right. No one knows their loved one better. This service provides an important safeguard that ensures concerns are heard and acted upon quickly.”
Martha’s Rule is a national approach across the NHS to strengthen patient and family involvement in recognising deterioration and reassuring people that it is always appropriate to ask for help. Call 4 Concern supports this approach by offering a clear route for patients and families to escalate concerns directly to a clinical team trained in recognising acute illness.
Call 4 Concern should be used only when there are worries about a patient’s condition getting worse or not improving as expected. It is available while the patient is in hospital and is specifically for concerns about a patient’s clinical condition, rather than general queries or feedback about care.
More information about our C4C service can be found on our website.
