Jess’s Rule Rolls Out Nationwide To Transform Cancer Diagnosis

In every corner of England’s healthcare system, a new rule is taking root—one born from tragedy but driven by hope. As of this week, every one of England’s 6,170 GP practices is displaying posters for Jess’s Rule, a protocol designed to prevent missed or late diagnoses, especially of serious conditions like cancer. The initiative, introduced in September 2025, is named in memory of Jessica Brady, a young engineer from Stevenage whose story has already left a deep mark on the nation’s approach to patient care.

Jessica Brady’s experience is a sobering one. In the months leading up to her death in 2020 at the age of 27, she contacted her GP surgery around 20 times over six months, reporting persistent symptoms including abdominal pain, coughing, vomiting, and unexplained weight loss. According to The Independent, pandemic-era restrictions meant she was often offered virtual appointments, prescribed medications such as antibiotics and steroids, and even told she might be suffering from long Covid. Despite her repeated visits, her symptoms were not properly investigated—she was considered too young for anything serious. Only after her mother, Andrea Brady, paid for a private consultation was Jessica finally diagnosed with stage four adenocarcinoma, a cancer that had already spread throughout her body. She died in hospital three weeks later.

Jessica’s mother, Andrea Brady, has been at the forefront of the campaign that led to the creation of Jess’s Rule. She explained, “Throughout her illness, Jess showed a quiet determination that her experience should lead to meaningful change, inspiring the launch of Jess’s Rule in September last year. I am so incredibly proud of my caring and courageous daughter.” She added that the Jessica Brady CEDAR Trust, the charity established in her daughter’s name, has been “heartened by the response from primary care practitioners adopting ‘the Three Strikes and We Rethink’ approach.”

So, what exactly does Jess’s Rule entail? The core principle is simple but powerful: if a patient attends three appointments for the same unresolved symptoms, or if their condition worsens, GPs are required to take a “fresh eyes” approach. This means reconsidering initial diagnoses, seeking a second opinion, conducting face-to-face physical examinations, or ordering additional diagnostic tests. The aim is to ensure that serious illnesses, including cancer, are identified and treated earlier—a goal Andrea Brady remains hopeful will be achieved.

The rollout of Jess’s Rule has been thorough. Posters, co-designed by the Department of Health and Social Care (DHSC), NHS England, and Jessica’s parents, now hang in consultation rooms across the country. According to the Daily Express, these visual reminders reinforce the principle of “Three strikes, and we rethink,” placing the guidance front and center where clinicians make critical decisions about diagnosis and treatment plans. GP surgeries have also received letters from Health Secretary Wes Streeting and NHS England’s national medical director, Dr. Claire Fuller, underscoring the importance of the initiative.

Health Secretary Wes Streeting has been vocal in his support, calling Jess’s Rule “a fitting tribute to Jessica Brady and the tireless campaigning of her parents.” He said, “Every patient deserves to be heard, and every serious illness deserves to be caught early. Jess’s Rule makes that possible—reminding clinicians to take a fresh look when symptoms persist, and empowering patients to speak up about their care.” He praised the Bradys’ determination to turn tragedy into lasting change, adding, “Their determination to turn tragedy into lasting change will help protect patients and save lives for years to come.”

Dr. Claire Fuller, national medical director for NHS England, echoed these sentiments, stating, “Encouraging GP teams to challenge a diagnosis when it matters most could save lives by avoiding missed or late diagnoses, and I’d like to thank Andrea and Simon Brady and the Jessica Brady CEDAR Trust for funding and providing their important insights to develop the posters.” She emphasized that Jess’s Rule is about reinforcing best practice and ensuring that clinicians remain vigilant, especially when a patient’s symptoms don’t fit the usual patterns.

Professor Victoria Tzortziou Brown, chairwoman of the Royal College of GPs, highlighted the significance of the initiative. She remarked, “Jess’s story is an important reminder that sometimes a rare diagnosis could be the right diagnosis. Jess’s Rule formalizes ‘best practice’ in general practice and underlines the importance of taking time to reflect and review a diagnosis, if a treatment plan doesn’t seem to be working.” She noted that this might mean having a more in-depth conversation with the patient, seeking a colleague’s second opinion, or making a referral to secondary care. “Timely diagnosis can mean better outcomes for patients—but many serious 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.”

The implementation of Jess’s Rule comes as research by the Nuffield Trust and the Health Foundation reveals a worrying trend: half of 16 to 24-year-olds required three or more interactions with a GP surgery before being diagnosed with cancer, compared with just one in five across the general population. The hope is that Jess’s Rule will help address this gap by prompting earlier and more thorough investigations, particularly for younger patients whose symptoms might otherwise be dismissed.

Already, the response from the medical community has been encouraging. Andrea Brady observed, “Many have committed to developing further training, while others have written to patients to endorse the initiative and show their support. This level of engagement has been profoundly encouraging.” The Royal College of GPs has also collaborated with the Jessica Brady CEDAR Trust to develop learning resources for GPs on diagnosing cancer in younger people.

Of course, the success of Jess’s Rule will depend on how well it is adopted and integrated into daily practice. The Department of Health and Social Care hopes the posters and guidance will boost patient safety by urging family doctors to challenge initial assumptions and keep an open mind when symptoms persist. As Dr. Fuller put it, “These posters will help reinforce the important principle of Jess’s Rule, ‘Three strikes, and we rethink’, which will be displayed in consultation rooms where clinicians make key decisions relating to a patient’s diagnosis and treatment plan day-to-day.”

For many, Jess’s Rule represents a much-needed shift in the culture of primary care—one that encourages reflection, humility, and a willingness to question the obvious. It’s a recognition that even experienced clinicians can miss the signs of something serious, and that a simple reminder to pause and reconsider could be the difference between life and death.

Jessica Brady’s legacy is now woven into the fabric of England’s healthcare system. Through the tireless advocacy of her family and the support of the medical community, her story is helping to ensure that others receive the timely, attentive care she was denied. It’s a testament to the power of persistence, compassion, and the unwavering belief that every patient—no matter their age—deserves to be heard and helped.