Going to see your doctor, or having a hospital appointment, can be a worrying experience, and it can also be intimidating.
You are going to the appointment because something is wrong, or not quite right, and you need their help.
We are often taught from a young age that “doctors know best”, so it is completely normal to feel unsure about asking questions of the healthcare professionals treating you, challenging their decisions, or insisting on answers.
Speaking up, or advocating, for yourself or for a loved one is an important and legitimate part of receiving safe, effective care, and you do not need to have had medical training to do it.
Being able to speak up for yourself helps you to stay informed about your care or treatment, involved in the decisions being made, and able to raise concerns when you do not understand something, if you need more of an explantion, or if your treatment is not progressing as expected. By doing this, you are not being difficult, you are a partner in your own healthcare journey.
This article offers practical tips that you can use to help you advocate for yourself or your loved ones in a healthcare setting. The article is not, and should not be viewed, as medical advice. You should speak to your doctors about any health concerns.
What Is Patient Advocacy and Why It Matters
Patient advocacy supports and empowers people (patients and caregivers) to deal with the complexities of the healthcare system, to help ensure that their rights are protected, and that their voices are heard, so that they receive the best possible care, information, and treatment
In some situations, patients have a patient advocate to support them in healthcare settings and they act as their voice or guide, but in most cases, people have to face their appointments alone and this can be intimidating.
Advocating for yourself can include asking questions, asking for clarity or more information about a diagnosis, requesting second opinions, and escalating concerns when progress stalls.
However, it can be hard to ask questions and easier instead accept what you are told, even when there are things that you do not understand. It is normal to feel this way. If you have no experience of medical matters, and even if you do, it can be scary to be told that something is wrong and / or that you need treatment. Your life could be changed in an instant during one appointment, and it can be an incredibly emotional and upsetting time.
There are many reasons for not wanting to speak up, including feeling like you are being “difficult”, worrying that you might offend the people treating you, or assuming that your clinical team know what they are doing and will notice and act on any issues, so you do not need to say anything.
It is completely understandable to feel this way, but there is nothing wrong in asking questions about your care or treatment. Raising an issue that has not been addressed, asking a question, or requesting information about different treatment options could mean that something is noticed or considered that would previously have been missed.
There are a few ways you can advocate for yourself:
- Ask questions until you understand: It is okay to say, “I am not sure I understand. Could you explain that again?”. There is usually only a limited time in an appointment, but that is your opportunity to speak to the healthcare professional treating you and to understand the decisions that are being made about your care, so you can ask questions.
- Be specific about your symptoms: Describe how your symptoms feel, how they have changed, and what impact they are having on you. Ask the healthcare professional to repeat what they have written about your symptoms, so that you know the records are accurate.
- Keep a symptom diary: Notes about when symptoms started or changed and what treatments you have tried can be helpful in discussions. If appointments are short, it can help a healthcare professional if you have a written record of what has been happening. It will also help you to remember the history of your condition and how things have changed.
- Bring someone with you if possible: A partner, friend, or relative can help ensure nothing is missed in conversation or on discharge paperwork. It can be hard to keep track of everything that is happening to you, especially if you are stressed or feeling emotional about your condition. Taking someone can benefit you because they are there for support and they can ask questions that you have not thought of, or are too distracted to ask. Speak to them before the appointment to let them know what you want to understand and then they can ask any questions that you forget about.
- Ask for escalation or a second opinion: If you are not satisfied with the answers that you have received, or you think that you have not been given all of the relevant information and would like a second opinion then there are processes within the NHS that exist to help you do this. You do not have to stay silent if you feel uncomfortable about the care that you have received.
Support available: Martha’s Rule and Jess’s Rule
What is Martha’s Rule?
Martha’s Rule is an NHS initiative that allows patients, their families, or carers to request an urgent clinical review when they have concerns that a patient’s condition is getting worse and that measures are not being taken to help them. The purpose of Martha’s Rule is to support early detection of deterioration in a patient before it is too late and to reinforce the importance of listening to patients and their families in order to deliver safe care.
Martha’s Rule was introduced following the tragic death of Martha Mills. Martha was in hospital after an accident and her condition started to deteriorate. Her family repeatedly raised concerns to her doctors because they could see that she was getting worse, but their concerns were not acted upon appropriately and Martha died. If doctors had listened to her family, her death would most likely have been avoided.
Martha’s Rule says that:
- You, your relative, or a carer can ask for a senior review of the clinical situation if a person’s condition is worsening and those raising concerns feel unheard.
- A clinician not previously involved in the case should promptly assess the patient’s condition.
- The purpose is to make sure clinically significant changes are recognised and acted upon before harm occurs.
What is Jess’s Rule?
In September 2025, NHS England and the Department of Health and Social Care launched Jess’s Rule: Three Strikes and We Rethink.
Jess’s Rule is safety initiative that focuses on primary care, especially care provided by GPs. The Rule was created in memory of Jessica Brady, a 27-year-old woman who tragically died of undiagnosed cancer despite attending her GP practice many times with persistent symptoms. Jessica's family have campaigned for there to be a formal pathway that allows a patient’s case to be escalated for review after repeat presentations without a diagnosis.
Jess’s Rule encourages GP teams to “reflect, review and rethink” when a patient presents three times with the same symptoms or concerns and there is:
- No clear diagnosis, or
- Symptoms that persist, escalate, or remain unexplained.
The aim of Jess’s Rule is to reduce delays in diagnosis, especially in conditions such as cancer and other serious diseases where early detection can be life-saving or life-changing.
Jess’s Rule supports healthcare professionals to challenge the initial assumptions and take action where previous consultations have not got to the bottom of the problem.
Importantly, Jess’s Rule also supports patient confidence. Knowing that raising concerns repeatedly should prompt a review encourages patients not to dismiss or ignore their symptoms and to continue to seek help.
When should I ask for a second opinion?
If you are worried about your health, persistent symptoms, or a lack of progress in your care, you are well within your rights to ask questions and seek a more thorough review of your condition.
Martha’s Rule and Jess’s Rule are rooted in the understanding that patients understand themselves best and their concerns matter, especially when something does not feel right.
You do not have to be certain that something is seriously wrong to seek further information or clarification of what you have been told. If you are worried about persistent symptoms or an unexplained deterioration, then this is enough reason to speak up. Martha's Rule and Jess’s Rule exist to support both patients and clinicians in working together to achieve the best possible outcomes.
What Can You Do Next if You Are Still Concerned?
Sometimes, despite your best efforts to raise concerns, care may still fall short.
If you believe that poor communication, failure to listen, or a misunderstanding contributed to you suffering an injury that you would have otherwise avoided, then seeking legal advice can help you understand what happened.
If you decide to start a medical negligence claim, your specialist lawyer will investigate what happened and will explain whether the care that you received was of an appropriate standard. They will explain what options are available to you if you received substandard care.
Final Thoughts
Advocating for yourself or a loved one in healthcare can feel daunting, but it is also empowering and, in many cases, essential.
You are entitled to be informed, to ask questions, and to raise concerns. The NHS recognises this through initiatives like Martha’s Rule and Jess’s Rule, which improve patient safety and support clinicians to reconsider care when necessary.
Knowing your rights, having confidence to speak up, and understanding the options available to you can make a meaningful difference in the care you receive.
Quote from author. Gemma Lewis, Partner and Specialist Medical Negligence Solicitor from MDS, said "More than ever it is important for people to feel that they can speak up and advocate for themselves or their loved ones in a healthcare setting. We regularly hear of the pressures that the NHS is facing, which means that, unfortunately, mistakes can happen, and things can be missed. Speaking up can give you the confidence that everything possible has been considered in relation to your care and treatment.”
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