- Bolton NHS Foundation Trust and Bolton Deaf Society have been shortlisted for a prestigious national award recognising excellence in patient safety.
- The project is a partnership to ensure equitable access for Deaf patients in times of escalation using the Martha’s Rule national safety initiative.
- The model can be adopted by other NHS organisations to deliver more inclusive care.
The partnership has been named as a finalist in the Patient Involvement in Safety Award category at the HSJ Patient Safety Awards 2026, for their project “Martha’s Rule – Equitable Access for Members of the Deaf Community.”
The shortlisted project showcases a pioneering collaboration between the Trust and Bolton Deaf Society to ensure Deaf patients can access Martha’s Rule, a national initiative designed to help patients and families escalate concerns about a patient’s condition, in a safe, accessible and equitable way.
Through co-production, Deaf community members worked alongside our clinical and operational teams to identify and address the reliance on verbal communication within escalation processes.
Together, we co-designed and tested new approaches, including:
- Accessible escalation pathways that do not rely on spoken communication
- British Sign Language (BSL) resources explaining how and when to use Martha’s Rule
- Improved tools and processes to support Deaf patients to raise concerns independently
Dr Rauf Munshi, Medical Director at Bolton NHS Foundation Trust said:
“This project has helped remove barriers for Deaf patients at some of the most critical moments in their care, ensuring they can raise concerns confidently and independently. We are committed to continuing to reduce barriers for our patients in accessing the care and support they need.
“Being shortlisted is a fantastic recognition of what can be achieved when we truly listen to and work alongside our communities.”
It has reduced reliance on family members or informal workarounds, strengthened staff understanding of Deaf culture and communication needs, and identified and mitigated hidden risks within standard patient safety processes. Importantly, it has also created a transferable model that can be adopted by other NHS organisations to support more inclusive and equitable care.
Michael Stead, Advocate Lead at Bolton Deaf Society, said:
“It has been a pleasure to work with Bolton NHS Foundation Trust to create ground-breaking BSL videos for Martha’s Rule.
“Patient safety is paramount and unfortunately a lot of the time deaf people can almost be an after thought in these situations and in relation to information sharing. The biggest challenge is always communication so we are confident these videos will go a long way to breaking down these barriers.
“This collaborative work will help to raise awareness of this issue, prevent it from happening again and hopefully reach other areas of the NHS, which will in turn help more people within the deaf community. These are relatively small quite straight forward changes, however the positive impact is huge.”
The project has removed barriers to escalation, enabling Deaf patients and their families to raise concerns with confidence, autonomy and without delay.
Learning from the initiative has been shared widely across the Trust, with system partners and through national forums, helping to influence wider thinking on inclusive patient safety and co-production.
The partnership has also led to further improvements beyond Martha’s Rule, including enhanced access to BSL interpreters and ongoing collaboration to improve healthcare accessibility for Deaf communities.
The HSJ Patient Safety Awards celebrate outstanding practice across the NHS and wider healthcare sector, recognising initiatives that improve patient safety, experience and outcomes through innovation, collaboration and learning.
The winners will be announced at a national awards ceremony later this year, bringing together leading organisations and teams from across the UK.
