A vital patient safety initiative, known as Jess's Rule, is now being advertised in every single GP surgery across England. The move aims to prevent avoidable deaths by prompting doctors to reconsider diagnoses when patients return with unresolved symptoms.
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 leading to her death, she 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, prescribed antibiotics and steroids, and told she might have long Covid.
It was only after her mother, Andrea Brady, paid for a private consultation that Jessica received a diagnosis. Tragically, the cancer had already spread throughout her body, and she died in hospital three weeks later. Jess's Rule was formally launched in September 2025 to ensure such devastating oversights are less likely to happen again.
How the 'Three Strikes and Rethink' System Works
At its core, Jess's Rule is a 'three strikes and rethink' protocol. It urges GPs and their teams to actively reconsider a case when a patient has had three appointments for the same or worsening symptoms without a clear diagnosis.
When this threshold is reached, clinicians are encouraged to:
- Take a 'fresh eyes' approach and challenge their initial assumptions.
- Conduct a face-to-face appointment for a physical examination.
- Seek a second opinion from a colleague.
- Order further tests or consider a referral to specialist care.
Posters outlining this protocol, co-designed by the Department of Health and Social Care (DHSC), NHS England, and Jessica's parents, have been distributed to all 6,170 GP practices in England for display in consultation rooms.
National Support and a Campaign for Lasting Change
The initiative has received strong backing from health leaders and Jessica's family. 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."
Andrea Brady said the charity established in her daughter's name, The Jessica Brady CEDAR Trust, has been "heartened" by the response from primary care. "Many have committed to developing further training, while others have written to patients to endorse the initiative," she said.
Professor Victoria Tzortziou Brown, Chair of the Royal College of GPs, emphasised that the rule formalises existing best practice. "It underlines the importance of taking time to reflect and review a diagnosis, if a treatment plan doesn't seem to be working," she said.
The rollout is supported by research from the Nuffield Trust and the Health Foundation, which found 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.
By making this rule visible in every practice, the NHS hopes to empower both clinicians and patients, creating a lasting legacy from a profound personal tragedy.
