When Jessica Brady began feeling unwell in the summer of 2020, she could hardly have imagined that her persistent symptoms would go undiagnosed for months, leading to a tragedy that has now sparked major change across England’s healthcare system. The 27-year-old engineer at Airbus, known for her vibrant energy and sharp mind, reached out to her GP practice more than 20 times over five months, reporting a range of symptoms: unexplained weight loss, night sweats, chronic fatigue, a persistent cough, and noticeably enlarged lymph nodes. Despite her repeated appeals for help, Jessica was told her symptoms were likely due to long Covid and that she was too young for cancer. No specialist referral was made, and she was seen by six different doctors, including three face-to-face consultations.
Jessica’s condition rapidly deteriorated. By the time her family arranged a private appointment and she was finally referred to a specialist, the diagnosis came as a devastating blow: stage 4 adenocarcinoma, an advanced cancer for which there were no treatment options left. She was admitted to hospital and died just three weeks later, days before Christmas 2020.
Jessica’s story, as reported by BBC and other major outlets, has since become the catalyst for a new NHS England initiative: Jess’s Rule. Announced on September 23, 2025, Jess’s Rule aims to ensure that no patient in England slips through the cracks in the way Jessica did. Under this new guideline, GPs are urged to adopt a “three strikes and rethink” approach. If a patient has three appointments for the same or worsening symptoms, and a clear diagnosis remains elusive, doctors are now expected to take decisive action—whether that means arranging a face-to-face consultation for someone previously seen remotely, ordering additional tests, seeking a second opinion, or referring the patient to a specialist.
Health Secretary Wes Streeting did not mince words about the importance of the initiative. Calling Jessica’s death “a preventable and unnecessary tragedy,” he thanked her family for campaigning “tirelessly through unimaginable grief to ensure Jessica’s legacy helps to save the lives of others.” Streeting emphasized, “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.”
Jessica’s mother, Andrea Brady, has been a driving force behind the campaign for change. In an emotional interview with BBC Radio 4’s Today programme, Andrea described how Jessica, despite her shock and devastation, “showed unfailing courage, positivity, dignity, and love” in her final weeks. “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 recalled. “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.”
The rollout of Jess’s Rule comes amid growing recognition of the challenges GPs face in diagnosing serious illnesses, especially in younger patients and those from ethnic minority backgrounds. According to research cited by BBC and the Department of Health, younger people and ethnic minorities often face longer diagnostic delays because their symptoms may not match the typical 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 before being diagnosed with cancer, compared to just one in five across the broader population.
Professor Kamila Hawthorne, Chair of the Royal College of General Practitioners (RCGP), acknowledged the difficulties. “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,” she explained. “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 RCGP has worked closely with Jessica Brady’s family and the Jessica Brady CEDAR Trust to develop an educational toolkit for GPs focused on the early diagnosis of cancer in young adults. The initiative is designed not as a rigid law but as a strong reminder, aiming to make the “three strikes and rethink” approach standard practice across the country. The Department of Health notes that many GP practices already use similar methods in complex cases, but Jess’s Rule will ensure consistency and help reduce health inequalities by making sure every patient—regardless of age or background—receives the same high standard of care.
Dr. Claire Fuller, National Medical Director at NHS England, expressed gratitude for the efforts of Andrea and Simon Brady, saying, “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.”
Paul Callaghan, from Healthwatch England, echoed the importance of swift and consistent implementation, noting, “The news that Jess’s Rule is being introduced into the NHS will come as a relief to those living with the anxiety of worrying symptoms, but are unable to get a diagnosis. Jess’s Rule will also improve patient safety by ensuring more rapid diagnosis of cancer and other illnesses, and provide clarity to those experiencing sickness or ill health. It is vital that the rule is implemented quickly and consistently, and people can make informed decisions about their care. It’s also imperative that specialist teams have the resources to deal with potential increases in demand, resulting from increased referrals.”
Jess’s Rule is part of a broader push to improve patient safety and outcomes in the NHS, aligning with the government’s 10 Year Health Plan. It complements other recent initiatives, like Martha’s Rule, which empowers patients and families in acute hospitals to request urgent clinical reviews. The government has also announced plans to recruit over 2,000 extra GPs in a year, invest in more space for GP surgeries, and provide a record funding boost for practices—over £1 billion in 2025-26. Public satisfaction with GP services is reportedly on the rise, with 73.6% of patients describing their experience as “good,” according to recent ONS statistics, up 6.2% since July 2024.
For Andrea Brady and the nearly half a million people who supported the campaign, Jess’s Rule is a powerful legacy. It stands not only as a tribute to Jessica’s determination and courage but as a safeguard for countless others who might otherwise face similar fates. By making it standard for GPs to pause, reflect, and take action after three unresolved appointments, the NHS hopes to catch deadly illnesses sooner and save lives—one patient at a time.
