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Parents should be treated as part of a child’s care team in hospital, experts have said after a new study found that parent intuition is more likely to predict critical illness than various

vital signs used to measure health. It comes after the tragic case of Martha Mills, who died after her parents repeatedly raised concerns about her deterioration while in hospital. Martha

died in 2021 aged 13 after developing sepsis following a pancreatic injury when she fell off her bike. Her mother, Merope Mills, and her husband, Paul Laity, sounded the alarm about their

daughter’s health a number of times, but their concerns were brushed aside. A coroner ruled she would most likely have survived if doctors had identified the warning signs of her rapidly

deteriorating condition and transferred her to intensive care earlier. For the new study, experts from Monash University in Melbourne, Australia, analysed data on almost 190,000 emergency

hospital visits for children in Melbourne. Parents or caregivers were routinely asked: “Are you worried your child is getting worse?” In some 4.7% of cases parents said they were concerned

their child was deteriorating. The research team found that caregiver concern was “significantly” linked to the child being admitted to an intensive care unit (ICU) – when parents raised

concerns, children were four times more likely to need ICU care, compared with children of parents who were not concerned. Researchers also found that prenatal concern was associated with a

higher likelihood the child would need to be given help to breathe, or mechanical ventilation. And they found that parental concern was more strongly associated with ICU admission than

abnormal vital signs were – including abnormal heart rate, abnormal breathing or blood pressure. “Caregiver concern was more strongly associated with ICU admission than any abnormal vital

sign,” they wrote in the journal Lancet Child and Adolescent Health. There were 1,900 cases where parental concern was documented along with the timing of abnormal vital signs. The research

team noted that in almost one in five cases (19.3%) parents raised concerns about deterioration before vital signs indicated that the child was deteriorating. This could mean that taking

parents’ views into account could lead to earlier treatment, they added. Overall, they found that children of caregivers who voiced concerns were “more unwell, they were more likely to be

admitted to an inpatient ward, and stayed in hospital almost three times as long.” One of the lead authors of the paper, Dr Erin Mills, from Monash University’s School of Clinical Sciences

at Monash Health, said: “We know that parents are the experts in their children, but stories of parents not being heard, followed by devastating outcomes, are all too common. We wanted to

change that.” She added: “We wanted to test whether parent input could help us identify deterioration earlier – and it can. If a parent said they were worried, their child was around four

times more likely to require intensive care. That’s a signal we can’t afford to ignore. “Parents are not visitors – they are part of the care team. We want every hospital to recognise that

and give parents permission, and power, to speak up.” As a result of Martha’s death, Martha’s Rule is being piloted in NHS hospitals, which gives patients and their loved ones the right to a

second medical opinion. In March the House of Commons Health and Social Care Committee was told that thousands of patients or their loved ones have sought a second opinion about their NHS

care under the initiative. And more than 100 patients have been taken to intensive care “or equivalent” as a result.