A major new patient safety initiative, known as Jess's Rule, is being rolled out to every GP surgery in England this week. The protocol mandates that doctors must formally reconsider a patient's case if they have attended three consultations without a clear diagnosis or if their symptoms have worsened.
What is Jess's Rule and why was it created?
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 before her death, Jess contacted her GP surgery around 20 times with symptoms including abdominal pain, coughing, vomiting, and significant weight loss. During the pandemic, she was largely limited to remote consultations, prescribed various medications, and told she might have long Covid.
It was only after a private consultation, arranged by her mother, that Jess received her devastating diagnosis. The cancer had already spread throughout her body, and she passed away just three weeks later. Her parents, Andrea and Simon Brady, have since campaigned tirelessly to ensure other families do not suffer a similar tragedy.
How the new system will work in practice
Posters explaining Jess's Rule have been distributed to all 6,170 GP practices across England and are expected to be displayed in consultation rooms. The rule formalises a 'three strikes and rethink' approach. When triggered, it advises medical professionals to:
- Seek a second opinion from a colleague.
- Arrange a face-to-face appointment for a physical examination.
- Request additional testing or investigations.
Health Secretary Wes Streeting stated: "Every patient deserves to be heard, and every serious illness deserves to be caught early. Jess's Rule makes that possible – reminding clinicians to take a fresh look when symptoms persist."
Broad support from medical leaders and charities
The initiative has received strong backing from across the healthcare sector. Andrea Brady said the family's charity, The Jessica Brady CEDAR Trust, has been "heartened" by the positive response from primary care practitioners.
Dr Claire Fuller, NHS England's national medical director, commented: "Encouraging GP teams to challenge a diagnosis when it matters most could save lives by avoiding missed or late diagnoses." She thanked the Brady family for funding and providing insights to develop the awareness materials.
Professor Victoria Tzortziou Brown, Chair of the Royal College of GPs, noted that Jess's story is a vital reminder that a rare diagnosis can sometimes be correct. She said the rule underlines "the importance of taking time to reflect and review a diagnosis, if a treatment plan doesn't seem to be working." The College has also worked with the trust to create educational resources to help GPs better identify cancer in young people.
The move follows concerning research from the Nuffield Trust and the Health Foundation, which found that half of young people aged 16-24 needed three or more GP appointments before receiving a cancer diagnosis, compared to just one-in-five across all age groups.
