What Is Jess's Rule: How a 27-Year-Old's Death Urges Changes in How England's GPs Diagnose Patients

A new initiative from the NHS urges all GP practitioners in England to 'think again' if their patient visits them several times and they can't determine a diagnosis, or if their symptoms are progressing.

The new policy, called Jess's Rule, honours the late Jessica Brady. She went to see her GP more than 20 times after starting to feel something that was not right in her health during the summer of 2020.

The GP told her that she was experiencing symptoms related to long Covid, and she was 'too young' to have cancer.

By the end of the year, Brady died from advanced-stage 4 cancer at the age of 27.

In a statement posted by The Mirror, Health Secretary Wes Streeting called Brady's death an unfortunate incident.

'Jessica Brady's death was a preventable and unnecessary tragedy. I want to thank her courageous family, who have campaigned tirelessly through unimaginable grief to ensure Jessica's legacy helps to save the lives of others,' Streeting stated.

'Patient safety must be the bedrock of the NHS, and Jess's Rule will make sure every patient receives the thorough, compassionate, and safe care that they deserve, while supporting our hard-working GPs to catch potentially deadly illnesses.'

He added that he does not want to see more families endure what Brady's family had been through, and that the government had learned its lesson from tragedies like this to help make decisive action for improving patient safety.

Jess's Rule Explained

The new rule emphasises the importance of GPs staying alert to symptoms that could suggest more serious health conditions, no matter how old the patient is or what ethnicity they belong to.

Jess's Rule is not considered a law, but it serves as a strong reminder for medical practitioners to practice a 'three strikes and a rethink approach.' It means GPs must immediately act after three appointments with a patient whose symptoms are not improving or getting worse, to avoid unnecessary deaths.

Brady's family collaborated with the Royal College of General Practitioners (RCGP) to develop the new rule to prevent more cases like hers from happening.

The RCGP also stated that doctors never intend to miss any sign of serious illnesses, like cancer.

'Many conditions, including many cancers, are challenging to identify in primary care because the symptoms are often similar to other, less serious and more common conditions,' RCGP chair Prof Kamila Hawthorne said through BBC.

'If a patient repeatedly presents with the same or similar symptoms, but the treatment plan does not seem to be making them better - or their condition is deteriorating - it is best practice to review the diagnosis and consider alternative approaches.'

A Mother's Grief

Brady's mother, Andrea, talked about the pain of losing her child in an article on Metro.

She recalled how her daughter received online treatments during the Covid period. Jess initially complained about abdominal pain, gave her a UTI infection diagnosis and an antibiotic prescription despite not having a urine test.

Brady's symptoms worsen, including intermittent fevers and extreme fatigue. Her next GP appointment told her that she had long Covid symptoms, but her condition worsened after a few days.

Andrea shared that her daughter was only diagnosed with 'stage 4 cancer of an unknown primary,' which means she was at the advanced stage where the cancer origin cannot be identified.

'I am sure those doctors did not anticipate that six weeks later we would be standing in a bitterly cold church yard, confronted with the impossible task of burying our daughter,' Andrea stated.

The undiagnosed cancer of her daughter that led to her death prompted Andrea to campaign for Jess's Rule, which gathered 465,000 signatures.

'Jess's Rule may appear to be stating the obvious, but our campaign demonstrates this is sadly not the case,' she added.