Jess’s Rule: The Three-Visit Warning That Could Save Your Life, Rolled Out This Week Across GP Practices

GP surgeries across England will begin displaying new information this week about Jess’s Rule, a patient safety initiative designed to reduce missed or delayed diagnoses.

The rule encourages GPs to pause and rethink when a patient has attended three appointments with the same or worsening symptoms but no clear diagnosis. At that point, doctors are urged to review the case more closely and consider whether further action is needed.

What is Jess’s Rule?

Jess’s Rule is named after Jessica Brady, who was just 27 when she died in 2020 after her cancer went undiagnosed for months.

The rule was formally introduced in September last year and is now being promoted nationwide. It asks GP teams to take extra steps if a patient has:

• Attended three appointments without a diagnosis

• Reported symptoms that are continuing or getting worse

• Not improved despite treatment

At that point, GPs are encouraged to:

• Arrange a face-to-face appointment

• Seek a second medical opinion

• Request further tests or scans

• Consider a referral to hospital specialists

The aim is to ensure serious illnesses, including cancer are identified as early as possible.

Why the Rule Was Created

Jessica contacted her GP practice around 20 times over six months, reporting symptoms such as abdominal pain, coughing, vomiting and weight loss.

During the Covid pandemic, her appointments were mostly remote. She was prescribed medication including antibiotics and steroids and was later told her symptoms could be linked to long Covid.

It was only after her mother paid for a private consultation that Jessica was diagnosed with cancer, which had already spread throughout her body. She died just three weeks later in hospital.

Posters Sent to Every GP Surgery

Information posters explaining Jess’s Rule are now being sent to all 6,170 GP surgeries in England. They have been jointly developed by the Department of Health and Social Care, NHS England, and Jessica’s parents.

The Department of Health says the posters are designed to improve patient safety by reminding doctors to challenge initial diagnoses when symptoms persist.

Health Secretary Wes Streeting said the rule helps ensure patients are listened to and serious conditions are not missed.

GP practices will also receive guidance letters reinforcing the importance of the approach.

A Mother’s Campaign for Change

Jessica’s mum, Andrea Brady, later set up the Jessica Brady CEDAR Trust in her daughter’s memory.

She said Jess was determined that her experience should lead to change, and she has been encouraged by the response from GP practices across the country.

Many surgeries have already committed to additional training, while others have written directly to patients to explain and support the new approach.

Andrea hopes the rule will help doctors take a “fresh eyes” look when a patient returns for a third time with the same concerns — potentially saving lives.

Support from Doctors and Medical Bodies

Dr Claire Fuller, NHS England’s national medical director, said encouraging GP teams to question diagnoses at key moments could prevent missed or late diagnoses.

Meanwhile, Professor Victoria Tzortziou Brown from the Royal College of General Practitioners said Jess’s story highlights the importance of reviewing cases where treatment plans are not working.

She noted that symptoms of serious illnesses including cancer often resemble far more common conditions, making them difficult to spot in primary care.

The Royal College has since worked with Jessica’s family to develop learning resources to help GPs identify cancer in younger patients.

Why This Matters, Especially for Young People

Research by the Nuffield Trust and the Health Foundation has shown that half of young people aged 16–24 needed three or more GP appointments before receiving a cancer diagnosis.

In comparison, only one in five people in the general population needed that many appointments.

Jess’s Rule aims to close that gap by ensuring repeated visits act as a trigger for review, not reassurance alone.

What Patients Should Know

Jess’s Rule does not mean patients are limited to three appointments and it does not blame GPs or patients.

Instead, it provides a clear reminder that:

• Ongoing symptoms matter

• It is OK for patients to speak up if they feel something isn’t right

• Reassessment can save lives

Posters explaining the rule are expected to be displayed in GP waiting areas and consultation rooms across England in the coming weeks.