Study 8. Evaluating predictive validity of the PWQ (NHSE responsive project)

A simple patient questionnaire could prove as reliable as clinical checks at spotting when someone in hospital is about to get dangerously worse. The problem is that current early warning systems rely on nurses and doctors taking vital signs like pulse and blood pressure. These checks happen at set intervals, so deterioration can be missed between rounds. Martha’s Rule, now being piloted in NHS hospitals, gives patients and families a direct way to escalate concerns. This study tests whether the Patient Wellness Questionnaire—a short self-assessment form—can flag deterioration as accurately as the standard National Early Warning Score. If the questionnaire works, it would give hospitals a low-cost, patient-centred tool to catch deterioration earlier, potentially reducing cardiac arrests, deaths, and intensive care admissions. The results will directly inform NHS England’s decisions on rolling out Martha’s Rule more widely. The study draws data from two large teaching hospitals already using the questionnaire in the pilot, comparing responses against clinical outcomes. This is applied health services research with a clear, near-term policy payoff: a faster, more inclusive safety net for hospital patients.