Jess’s Rule: New NHS Initiative to Catch Deadly Illnesses Earlier
A new NHS initiative called Jess’s Rule is being rolled out across England today, aiming to ensure patients with potentially life-threatening illnesses are diagnosed sooner.
Named in memory of Jessica Brady, who tragically died of cancer at 27, the programme seeks to prevent deaths caused by missed or delayed diagnoses.
Jessica had more than twenty appointments with her GP in the five months before her death in December 2020.
Unable to get a clear diagnosis, she turned to private healthcare, where she was diagnosed with stage 4 adenocarcinoma, too late for treatment. She passed away three weeks later.
Jess’s Rule will prompt GPs to reevaluate a case’s care if, after three movables, no definitive opinion has been reached or symptoms worsen.
While some practices formerly took an analogous approach in complex cases, the action will standardise this across the NHS, aiming to reduce health inequalities and ensure high-quality care for all cases.
The programme, developed in cooperation with NHS England and the Royal College of General Practitioners, will give GPs with structured guidance to reflect, review, and reevaluate when faced with uncertain cases.
Jess’s mum, Andrea Brady, said: “Jess lived for just three short weeks following her terminal cancer diagnosis. Despite her shock and devastation, she showed unfailing courage, positivity, dignity, and love.
Jess was determined that people should understand how desperately she had tried to advocate for herself and seek a resolution for her declining health.
In the bleak weeks following the loss of Jess, I realised it was my duty to continue what she had started. It has taken nearly five years to bring about Jess’s Rule. I would like to dedicate this initiative to all the young people who have been diagnosed too late.”
She added that the crusade’s success was thanks to wide support from politicians, croakers, and nearly half a million members of the public.
Health and Social Care Secretary Wes Streeting commented: “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.
Patient safety must be the bedrock of the NHS, and Jess’ 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.
I don’t want any family to endure the pain Jessica’s family has been through. This government will learn from such tragedies and is taking decisive action to improve patient safety.”
How Jess’s Rule Works?
The initiative encourages GPs to:
- Arrange face-to-face consultations if previous appointments were remote.
- Conduct detailed physical examinations.
- Order additional diagnostic tests.
- Review patient records thoroughly.
- Seek second opinions or specialist referrals when needed.
Studies show that young people and ethnical nonage cases are frequently diagnosed later than others, as their symptoms may differ from typical patterns.
An exploration by the Nuffield Trust and the Health Foundation found that half of 16 24- time- pasts demanded three or further GP consultations before a cancer opinion, compared with just one in five of the wider population.
Jess’s Rule aims to address these inequalities, ensuring that symptoms are taken seriously, regardless of age or background.
Dr Claire Fuller, National Medical Director at NHS England, said: “I am very humbled by the efforts of Andrea and Simon Brady, who have campaigned for this important initiative which will undoubtedly save lives by avoiding missed or delayed diagnoses and ensuring patients receive the right treatment at the right time.
Many clinicians already apply a version of ‘three strikes and rethink’ in their routine practice, but Jess’s Rule formalises this instinctive approach, providing a consistent structure to support reflection and timely action for patients.”
Professor Kamila Hawthorne, Chair of the Royal College of GPs, added: “No GP will ever want to miss signs of serious illness, such as cancer.
Ensuring a timely diagnosis often means better outcomes for patients, but 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.
Alternative diagnoses are often more likely, particularly when considering risk factors such as age.
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.
We hope that by formalising this with Jess’s Rule, it will remind GPs to keep this at the forefront of their minds.
The College has also worked with Jess Brady’s family and the Jessica Brady CEDAR Trust to develop an educational resource for GPs on the early diagnosis of cancer in young adults, based around the principles of Jess’s Rule.”
Jess’s Rule strengthens patient voices in healthcare and builds on initiatives such as the NHS plan to offer free chickenpox vaccines for children, which also aims to improve early intervention and public health outcomes.
The government’s Plan for Change also includes recruitment of 2,000 extra GPs in a year, investment in over 1,000 GP surgeries, and a record funding boost of more than £1 billion for 2025-26.
Public satisfaction with GP services is rising, with 73.6% of patients rating their GP experience as “good,” up from 67.4% in mid-2024.
By catching serious illnesses earlier, Jess’s Rule promises to reduce hospital backlogs, improve outcomes, and save lives.
