A major new patient safety initiative, known as Jess's Rule, is being introduced to every GP surgery in England this week. The system is designed to prompt family doctors to reassess a patient's case if they have had three appointments for the same symptoms without receiving a clear diagnosis.
The Tragic Story Behind the Rule
The rule is named in memory of Jessica Brady, a 27-year-old engineer from Airbus who died from cancer in 2020. In the six months leading up to her death, Jessica contacted her GP surgery around 20 times, reporting symptoms including abdominal pain, coughing, vomiting, and weight loss.
During the pandemic, she was largely offered virtual appointments and prescribed medications like antibiotics and steroids, with suggestions she might have long COVID. It was only after her mother, Andrea Brady, paid for a private consultation that Jessica received a diagnosis of advanced, widespread cancer. She passed away in hospital just three weeks later.
How Jess's Rule Will Work in Practice
First rolled out in September, the 'three strikes and rethink' approach is now being formally advertised in all 6,170 GP practices across England via posters. Under the rule, clinicians are encouraged to take specific actions when initial treatment isn't working, including:
- Conducting a face-to-face appointment for a physical examination.
- Seeking a second opinion from a colleague.
- Ordering further diagnostic tests.
The Department of Health and Social Care states that displaying these posters will boost safety by urging GPs to challenge their initial assumptions.
National Support and a Family's Campaign
Health Secretary Wes Streeting said the rule ensures every patient is heard and helps catch serious illnesses early. He called it a fitting tribute to Jessica and the tireless campaigning of her parents, Andrea and Simon Brady, who co-designed the posters with the DHSC and NHS England.
Andrea Brady said the charity set up in her daughter's name, The Jessica Brady CEDAR Trust, has been 'heartened' by the response from primary care. Many practitioners have committed to further training or written to patients to endorse the initiative.
Dr Claire Fuller, NHS England's National Medical Director, emphasised that encouraging GP teams to challenge a diagnosis when it matters most could save lives by avoiding missed or late diagnoses. Professor Victoria Tzortziou Brown, Chair of the Royal College of GPs, noted the rule formalises 'best practice', underlining the importance of taking time to reflect if a treatment plan isn't working.
Research by the Nuffield Trust and the Health Foundation highlights the need for such measures, finding that half of 16 to 24-year-olds required three or more GP interactions before a cancer diagnosis, compared to just one-in-five across the general population.
