- GPs across England to take “three strikes and rethink approach” after three appointments – as Jess’s Rule rolled out nationwide to prevent avoidable deaths
- Move will save lives and help catch serious, deadly conditions earlier, particularly in young people
- Named after Jessica Brady, who tragically died of cancer aged 27 after twenty appointments at her GP surgery failed to diagnose her condition
Patients with a potentially deadly illness will be diagnosed sooner through a new life-saving patient safety initiative called Jess’ Rule that is being rolled out across the NHS in England today [23 September 2025].
Jess’s Rule is named in memory of Jessica Brady, who died of cancer in December 2020 at the age of 27, and will help avoid tragic, preventable deaths as GPs are supported to catch potentially deadly illnesses sooner.
In the five months leading up to her death, Jessica had more than twenty appointments with her GP practice but eventually had to seek private healthcare. She was later diagnosed with stage 4 adenocarcinoma. With such an advanced disease there was no available treatment. She was admitted into hospital where she died three weeks later.
The new initiative will ask GPs to think again if, after three appointments, they have been unable to offer a substantiated diagnosis, or the patient’s symptoms have escalated.
While many GP practices already use similar approaches in complex cases, Jess’s Rule will make this standard practice across the country, aiming to reduce health inequalities and ensuring everyone – no matter their age or background – receives the same high standard of care.
Designed in collaboration with the Chair of Royal College of General Practitioners (RCGP) and NHS England, Jess’s Rule will help to catch serious conditions earlier and support GPs with guidelines that bolster their clinical judgment, while encouraging them to reflect, review and rethink if they are uncertain about a patients’ condition.
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.
It has only been made possible because of the people who have listened — politicians, medics, and the nearly half a million who supported the campaign.
Health and Social Care Secretary Wes Streeting said:
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 have been through. This government will learn from such tragedies and is taking decisive action to improve patient safety.
Jess’s Rule could support GPs to ensure continuity of care for patients with persistent health concerns. This could involve arranging face-to-face consultations if previous appointments were remote, conducting thorough physical examinations, or ordering additional diagnostic tests.
It also encourages GPs to review patient records comprehensively, seek second opinions from colleagues, and consider specialist referrals when appropriate.
Research shows that younger patients and those from ethnic minority backgrounds often face delays in diagnosis of serious conditions, as their symptoms may not match typical presentation patterns seen in older or white patients.
A report from the Nuffield Trust and the Health Foundation found that half of 16 to 24-year-olds required three or more interactions with a healthcare professional from a GP practice before being diagnosed with cancer, compared to one in five across the whole population.
Jess’s Rule emphasises the need to remain alert to symptoms that might suggest serious conditions, regardless of a patient’s age or ethnicity, thereby reducing health inequalities.
Dr Claire Fuller, National Medical Director at NHS England says:
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, said:
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.
Jessica Brady’s legacy will ensure that patient voice is at the heart of healthcare – a key commitment in the government’s 10 Year Health Plan.
This initiative, targeting primary care, builds on the recent rollout of Martha’s Rule to every acute hospital in England, which empowers patients, families, and carers to request urgent clinical reviews if they are concerned about deteriorating conditions not being adequately addressed.
Jess’s Rule is just one of the ways the government is supporting GPs to provide worldclass healthcare for patients as part of the Plan for Change.
This includes recruiting over 2,000 extra GPs in a year, providing vital cash for over 1,000 GP surgeries to create additional space to see more patients, and securing a record funding boost for practices – over £1 billion in 2025-26. Public satisfaction with GP services is finally on the rise, with 73.6% of patients describing their GP experience as “good” according to recent ONS statistics, up 6.2% since July 2024.
By catching illnesses at earlier stages, Jess’s Rule will help reduce hospital backlogs, improve outcomes for patients, and save lives.
