Call 4 Concern (C4C)

Call 4 Concern© is a patient safety service enabling patients and families to call for immediate help and advice when they feel concerned that the health care team has not recognised their own or their loved one’s changing condition (deterioration).

Patient Safety is a high priority in Homerton Healthcare, especially when a patient’s condition deteriorates.

C4C is delivered by the Critical Care Outreach Team (CCOT) who are available 24 hours a day to help support ward teams and you.

Martha’s Rule

The first phase of the introduction of Martha’s Rule will be implemented in the NHS from April 2024. Once fully implemented, patients, families, carers and staff will have round-the-clock access to a rapid review from a separate care team if they are worried about a person’s condition.

Martha Mills died in 2021 after developing sepsis in hospital, where she had been admitted with a pancreatic injury after falling off her bike. Martha’s family’s concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier.

In response to this and other cases related to the management of deterioration, the Secretary of State for Health and Social Care and NHS England committed to implement ‘Martha’s Rule’; to ensure the vitally important concerns of the patient and those who know the patient best are listened to and acted upon.

Read more about Martha’s Rule on the NHS England website: NHS England » Martha’s Rule or in our  Call 4 Concern patient information leaflet.

When to make a C4C call

Call the Critical Care Outreach team if:

  • you have ongoing concerns after you have spoken to the ward nurse or doctor
  • there is a noticeable change in your own, or the patient's condition and the ward team is not recognising your concern.

Contact us by calling 07557 157 464

Responding to your call

When the Critical Care Outreach team receive your call, they will need to know:

  • Your name (if you are the patient) or the name of the patient you are concerned about AND date of birth
  • The ward
  • A brief description of the problem.

After visiting you / the patient, we will contact you and update you on any action taken. CCOT will liaise with the medical team and other healthcare professionals as needed.

Sometimes, we are unable to take your call immediately, but you can leave a message providing the information as stated above, and a contact number. We will get back to you as soon as possible.

When not to make a C4C call.

  • If you have a problem regarding your hospital bed, room, food, parking or any other general issues please speak to a member of the ward team or ask for the Nurse in Charge
  • You can also contact the ward Matron to discuss any issues further.

C4C is a patient safety service aimed at preventing clinical deterioration.

Please contact the Patient Advice & Liaison Service (PALS) if you have any other concerns regarding the care that you or a relative or friend is receiving, that has not been resolved by talking with the ward team.

If you are a staff member, please contact the Freedom to Speak up Guardian with any concerns about patient safety, quality of care, bullying or staff safety and wellbeing. Contact details can be found on the staff intranet.