The new initiative called Jess’s Rule is named after Jessica Brady, who died from advanced stage four cancer in 2020 aged 27.
Before her eventual diagnosis, the Airbus engineer from Stevenage had contacted her GP on more than 20 occasions after feeling unwell, but was told her symptoms were related to long Covid and that she was “too young for cancer”.
Her family then arranged a private appointment and she was referred to a specialist, who gave Jess a terminal cancer diagnosis of adenocarcinoma – cancer of the glands that line the organs – in November. She died three weeks later, just days before Christmas 2020.
Under Jess’s Rule, GPs are asked to take a “fresh eyes” approach if they have been unable to offer a patient a substantiated diagnosis or their symptoms have escalated after three appointments.
It has a ‘three strikes and we rethink’ approach:
Reflect: Think back on what the patient has said and consider what has changed or been missed. Offer ongoing continuity of care with follow-up. If previous consultations have been remote, see the patient face-to-face and conduct a physical examination.
Review: Where underlying uncertainty exists, consider seeking a view from a peer and review any red flags that may suggest another diagnosis, regardless of the patient’s age or demographic.
Rethink: If appropriate, refer onwards for further tests or for specialist input
The government said the consultation room posters would improve patient safety by prompting doctors to “revisit patient records, challenge initial assumptions and remain alert to warning signs that might otherwise be missed”.
Health Secretary Wes Streeting said: “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 posters were designed by Jess’s parents Andrea and Simon in partnership with NHS England and the Department of Health, and funded by the Jessica Brady Cedar Trust established in her honour.
Dr Claire Fuller, NHS England’s national medical director, said: “Encouraging GP teams to challenge a diagnosis when it matters most could save lives by avoiding missed or late diagnoses.”
