The NHS has launched a new patient safety measure encouraging doctors to reassess their approach when patients return repeatedly with unresolved health concerns.
The initiative, known as Jess's Rule, instructs GPs across England to reconsider their initial assessment if someone attends three appointments presenting similar symptoms without improvement.
The guidance takes its name from Jessica Brady, a 27-year-old aerospace engineer who passed away from advanced cancer in 2020.
Despite contacting her surgery more than 20 times over several months, her condition went undiagnosed until it was terminal.
Jessica consulted six different doctors at her practice over five months
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The measure represents a significant shift in primary care practice, aiming to reduce preventable deaths through earlier detection of serious conditions. It underscores the importance of thorough investigation when standard treatments prove ineffective.
Jessica Brady, an engineer at Airbus working on satellite design, began experiencing health problems in July 2020.
Her mother Andrea revealed on Radio 4's Today programme that her daughter suffered from significant weight loss, night sweats, severe exhaustion, persistent coughing and swollen lymph nodes.
Over five months, Jessica consulted six different doctors at her practice and attended three in-person appointments.
Medical staff dismissed her concerns, attributing symptoms to long Covid and stating she was "too young for cancer".
By the time the family arranged private care and secured a specialist referral, Jessica received a terminal diagnosis of adenocarcinoma.
She died three weeks later in December 2020, shortly before Christmas.
"Her body was failing her," Andrea said, describing how her daughter struggled to advocate for herself after repeated dismissals.
The guidance operates on a "three strikes and rethink approach", prompting doctors to take decisive action when patients attend multiple appointments with persistent symptoms.
This could involve scheduling in-person consultations for those previously assessed remotely, requesting additional diagnostic tests, or seeking input from colleagues.
GPs are also encouraged to refer patients to specialists when standard treatments prove unsuccessful.
The Royal College of General Practitioners, which helped develop the guidance, acknowledged that many illnesses present diagnostic challenges in primary care settings.
"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," stated RCGP chair, Professor Kamila Hawthorne.
Studies indicate that younger individuals and those from ethnic minority communities frequently experience diagnostic delays, as their symptoms may differ from typical presentations seen in older or white patients.
Young people often face dismissal due to assumptions about age-related health risks.
The RCGP collaborated with Jessica Brady's family to create educational materials focusing on early cancer detection in young adults.
The Department of Health acknowledged that whilst numerous practices already follow appropriate procedures, implementing Jess's Rule would establish this as routine practice nationwide.
Jessica received a terminal diagnosis of adenocarcinoma
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"She wanted to make a difference," Andrea Brady said of her daughter. "Jess knew her delayed diagnosis was instrumental in the fact that she had no treatment options open to her, only palliative care. She felt strongly that she didn't want this to happen to other people."
Health Secretary Wes Streeting described Jessica Brady's death as "a preventable and unnecessary tragedy", praising her family for their tireless campaigning despite their profound loss.
He said that the new rule would strengthen patient safety standards and assist GPs in identifying potentially fatal conditions.
"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," Streeting said.
Paul Callaghan from Healthwatch England stressed the need for rapid and uniform implementation of the guidance.
He cautioned that specialist services must receive adequate resources to manage potential increases in referrals resulting from the new approach.