Written question WQ100644

Call for Concern is the patient and family escalation process being introduced across NHS Wales. As the Welsh equivalent of Martha's Rule in England, it reflects the same core principles while also incorporating learning from Ryan's Rule in Australia. It gives patients, families and carers a clear route to raise urgent concerns if they believe a patient’s condition is deteriorating.

It will be available across adult, children's, maternity and neonatal inpatient services, providing a consistent approach across Wales. By 30 September all health boards are expected to demonstrate that ‘patient self-reported wellness’ is reliably documented at least twice daily in all acute hospitals in-patient areas, and by 31 December all health boards are expected to demonstrate reliable use of the patient and family-initiated escalation approach in all acute and non-acute in-patient settings.

Call for Concern complements, rather than replaces, existing clinical systems used to identify deterioration. In September 2025 NHS Wales implemented a suite of Early Warning Scores, including National Early Warning Score 2 (NEWS2), Paediatric Early Warning Score (PEWS), Neonatal Early Warning Trigger and Track.