For patients in England who have struggled to get a diagnosis despite repeated visits to their general practitioner, a new law known as Jess’s Rule promises a lifeline. Announced by the government on September 23, 2025, and set to be rolled out nationwide, the rule urges GPs to take a "three strikes and rethink" approach for patients who have attended three appointments for the same unresolved or worsening symptoms without a substantial diagnosis. In a health system often stretched to its limits, this mandate aims to prevent avoidable tragedies like that of Jessica Brady, the young woman whose story inspired the reform.
Jessica Brady, a 27-year-old engineer from Stevenage, died in 2020 after her cancer went undiagnosed despite approximately 20 contacts with her GP surgery over a six-month period. Her symptoms—abdominal pain, coughing, vomiting, and weight loss—were attributed to less serious causes, with doctors telling her she was suffering from long COVID and that she was too young for her symptoms to signal anything more sinister. Most of her appointments were virtual, a necessity during the COVID-19 pandemic, and she was given antibiotics and steroids. It was only after her mother paid for a private consultation that her cancer was finally discovered; by then, it had spread throughout her body. Jessica was placed on oxygen and died in hospital three weeks later.
According to The Independent, the government’s new rule formalizes a practice already used in some complex cases, making it standard across the country. Under Jess’s Rule, doctors are encouraged to consider a second opinion, arrange face-to-face examinations, order additional tests, or make specialist referrals if a patient’s symptoms persist or worsen after three appointments without a clear diagnosis. The initiative was developed in partnership with the Royal College of GPs (RCGP) and NHS England, with the Department of Health and Social Care (DHSC) emphasizing the importance of timely and thorough care for all patients.
The story behind Jess’s Rule is one of heartbreak, advocacy, and determination. Jessica’s mother, Andrea Brady, has campaigned for nearly five years to ensure that other young people do not experience the same fate as her daughter. "Jess lived for just three short weeks following her terminal cancer diagnosis," Andrea recalled, as quoted by BBC News. "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."
Andrea Brady’s campaign garnered the support of nearly half a million people, as well as politicians and medical professionals. "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," she said.
Health and Social Care Secretary Wes Streeting described Jessica’s death as "a preventable and unnecessary tragedy." In a statement, he added, "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. I don’t want any family to endure the pain Jessica’s family have been through."
The new rule is not only about catching cancer earlier but also about shifting the culture within primary care to ensure persistent symptoms are never dismissed. Professor Kamila Hawthorne, chair of the Royal College of GPs, explained the challenge: "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."
Professor Hawthorne continued, "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." To support the implementation, the RCGP has helped create an educational toolkit for GPs focused on the early diagnosis of cancer in young adults.
Jessica’s case is, tragically, not unique. A report from the Nuffield Trust and the Health Foundation found that half of 16 to 24-year-olds needed three or more interactions with a GP surgery before being diagnosed with cancer, compared to just one in five across the general population. This disparity highlights the difficulty of diagnosing serious illnesses in younger adults, whose symptoms are often attributed to more benign conditions.
Jess’s Rule follows the introduction of Martha’s Rule, another patient safety initiative rolled out in September 2024. Named after 13-year-old Martha Mills, who died of sepsis in 2021 after her family’s concerns were not fully acted upon, Martha’s Rule allows relatives, patients, and carers to seek a rapid second opinion if they are worried about a patient’s condition. Both rules underscore the importance of listening to patients and their families—those who know the patient best and can spot subtle but significant changes in health.
The government’s announcement of Jess’s Rule has been met with cautious optimism by patient advocates and medical professionals alike. While many GP practices already employ similar strategies, the rule’s formalization is seen as a crucial step toward consistency and safety in primary care. As the NHS continues to grapple with resource limitations and the lingering effects of the pandemic, ensuring that persistent or worsening symptoms are thoroughly investigated could save countless lives.
For Andrea Brady and the many families touched by late diagnoses, Jess’s Rule represents both a legacy and a promise—a commitment that those who come after will have a better chance at timely, life-saving care. The hope is that, with this new approach, tragedies like Jessica’s will become ever rarer, and that every patient’s voice will be heard, no matter how many times they must ask for help.
