Jessica Brady’s name will now forever be linked to a sweeping change in the way the UK’s National Health Service approaches persistent, unexplained symptoms—especially among young people. The introduction of Jess’s Rule by NHS England marks a pivotal moment in patient safety, but it also exposes the complexities and challenges of reforming a strained healthcare system. Behind this new guidance is a story of heartbreak, advocacy, and a mother’s determination to ensure no one else faces the same fate as her daughter.
Jessica Brady was just 27 when she died on December 20, 2020, three weeks after finally being diagnosed with stage 4 adenocarcinoma, a cancer that had silently spread to her spine, liver, stomach, lungs, and lymph nodes. According to Mirror and other UK outlets, Jessica had contacted her GP practice about 20 times over six months, desperately seeking answers for a growing list of symptoms: persistent abdominal pain, coughing, vomiting, and significant weight loss. Despite her persistence, her symptoms were repeatedly dismissed as minor or attributed to Long Covid, even though she tested negative for the virus twice. Instead of comprehensive investigations, she was prescribed antibiotics and steroids—never the thorough in-person examination or escalation her condition warranted.
The COVID-19 pandemic made matters worse. Lockdowns and restrictions meant most of Jessica’s consultations were virtual, and crucial physical examinations were missed. Her mother, Andrea Brady, later reflected on the trauma of watching her daughter’s health deteriorate while feeling invisible to the healthcare system. “Jess lived for just three short weeks following her terminal cancer diagnosis,” Andrea said. “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.”
It was only after Andrea paid for a private referral that Jessica finally received her diagnosis. By then, options were limited. Jessica spent her final days in hospital, on oxygen, surrounded by loved ones. Her story, though devastating, galvanized her mother to campaign for change. Andrea’s efforts, supported by nearly half a million people, led to the creation of Jess’s Rule—a new national patient safety initiative announced by NHS England on September 23, 2025.
So what exactly is Jess’s Rule? The guidance urges GPs to adopt a “three strikes and rethink” approach: if a patient attends three appointments for the same symptoms without a clear diagnosis, or if their condition worsens, doctors must take additional steps. According to the Department of Health and Social Care, this means considering second opinions, conducting face-to-face physical exams, ordering further tests, and making specialist referrals when necessary. While many GP practices already use similar strategies for complex cases, Jess’s Rule aims to make this best practice the national standard.
The rule was developed in partnership with the Royal College of General Practitioners (RCGP) and NHS England. Professor Kamila Hawthorne, chair of the RCGP, explained, “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. 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 initiative is not without its critics. Some have pointed out that Jess’s Rule is, in practice, guidance rather than a binding law, and that NHS England itself has stated, “No additional training or materials are required for its implementation.” As The Spectator noted, the policy is more of a nudge than a mandate, and there are concerns that it may not address the deeper, systemic issues that lead to delayed diagnoses. NHS England’s own data reveals that 50% of young people need three or more appointments before a cancer diagnosis, compared to 20% for the general population—a reflection, experts say, of the rarity of cancer in youth rather than poor doctoring. However, critics argue that the UK’s overall performance in early cancer diagnosis remains poor across all age groups, and that more rigorous measures—such as auditing every cancer case in young people, standardizing review systems in general practice, and leveraging large datasets to study diagnostic delays—are urgently needed.
Despite these reservations, there is widespread agreement that Jess’s Rule represents an important cultural shift. Health and Social Care Secretary Wes Streeting described Jessica’s death as “a preventable and unnecessary tragedy,” adding, “Jess’s Rule will ensure every patient receives the thorough, compassionate, and safe care that they deserve, while supporting our hard-working GPs to catch potentially deadly illnesses.” The rule echoes a similar initiative, Martha’s Rule, named after 13-year-old Martha Mills, which empowers patients and families to seek second opinions if they have concerns—recognizing that those closest to a patient often notice critical changes first.
Andrea Brady, reflecting on the years-long campaign, said, “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.”
The debate over Jess’s Rule raises important questions: Will busy GP practices have the resources and time to implement the guidance effectively? Can a culture of vigilance and patient empowerment truly take hold in a system under constant strain? And most importantly, will this new approach save lives, or is it just another layer of bureaucracy?
What’s clear is that Jessica Brady’s story has left an indelible mark on British healthcare. Her family’s grief has been transformed into action, and her legacy is now a catalyst for national reflection and reform. Jess’s Rule is a promise that the NHS will strive to do better, to listen more closely, and to never let a patient feel invisible. Whether this guidance will be enough remains to be seen, but it stands as a testament to the power of advocacy, the importance of patient voices, and the enduring impact of one young woman’s fight for answers.
As the NHS rolls out Jess’s Rule across England, families, doctors, and policymakers alike are watching closely—hoping that this time, the system will truly learn from tragedy and ensure that no one slips through the cracks again.
