A new NHS initiative called “Jess’s Rule” aims to reduce avoidable deaths by ensuring GPs take urgent action when patients repeatedly report symptoms without a diagnosis. The protocol is named after Jessica Brady, a 27-year-old engineer who died of advanced cancer in December 2020.
In the months before her death she made over 20 appointments with her GP surgery, reporting symptoms such as weight loss, night sweats, persistent coughs, enlarged lymph nodes, and chronic fatigue, but was told she was “too young for cancer” and her problems were misattributed, including to long COVID.
“Despite her shock and devastation, she showed unfailing courage, positivity, dignity, and love,” Jess’s mum Andrea Brady said. “Jess was determined that people should understand how desperately she had tried to advocate for herself and seek a resolution for her declining health.”
From September 2025, GPs across England will be expected to adopt a “three strikes and rethink” approach. Under Jess’s Rule, if a patient attends three appointments with the same or worsening symptoms without a credible diagnosis, GPs should reconsider the case. This may mean moving from remote consultations to face-to-face review, arranging tests, seeking specialist referrals or second opinions.
The rule is designed to standardise across the country what many practices already do in complex cases, helping to catch serious illnesses sooner.
It also aims to address inequalities, since younger patients and people from ethnic minority backgrounds are more likely to experience delays in diagnosis. Health Secretary Wes Streeting called Jessica’s death “a preventable and unnecessary tragedy,” and said Jess’s Rule will improve patient safety.
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