A powerful new patient safety initiative, known as Jess's Rule, is being launched across every GP practice in England this week. The move aims to prevent missed diagnoses of serious conditions like cancer by encouraging doctors to fundamentally rethink cases where a patient has had multiple appointments without an answer.
What is Jess's Rule?
Jess's Rule promotes a "three strikes and rethink" approach for general practitioners. It urges them to seek a second opinion, order further tests, or conduct a face-to-face examination when a patient has attended three appointments without a diagnosis, or if their symptoms have notably worsened. The rule is named in memory of Jessica Brady, a 27-year-old Airbus engineer who died from cancer in 2020 after contacting her surgery around 20 times over six months.
During the pandemic, Ms Brady's symptoms of abdominal pain, coughing, vomiting, and weight loss were addressed through virtual appointments. She was prescribed antibiotics and steroids and was also told she might have long COVID. It was only after her mother paid for a private consultation that she received a terminal cancer diagnosis; the disease had spread throughout her body, and she died in hospital three weeks later.
A National Rollout to Save Lives
The rule was first introduced in September 2025, and its adoption is now being amplified nationwide. Posters explaining Jess's Rule have been distributed to all 6,170 GP clinics in England, co-designed by the Department of Health and Social Care (DHSC), NHS England, and Jessica's parents, Andrea and Simon Brady.
Every surgery will also receive a joint letter from Health Secretary Wes Streeting and NHS England's national medical director, Dr Claire Fuller, stressing the rule's critical importance. Dr Fuller stated that encouraging GP teams to challenge a diagnosis when it matters most "could save lives by avoiding missed or late diagnoses."
A Legacy of "Quiet Determination"
Andrea Brady said the charity founded in her daughter's name, the Jessica Brady CEDAR Trust, which helped fund the posters, has been "heartened" by the response from primary care. "Throughout her illness, Jess showed a quiet determination that her experience should lead to meaningful change," she said, expressing immense pride in her "caring and courageous" daughter.
Health Secretary Wes Streeting emphasised: "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, and empowering patients to speak up about their care."
The initiative is backed by research from the Nuffield Trust and the Health Foundation, which found that half of 16 to 24-year-olds needed three or more GP interactions before a cancer diagnosis, compared to just one-in-five across the general population.
