Jess’s Rule Rolls Out Nationwide To Transform GP Care

In a sweeping new effort to prevent tragic and avoidable deaths, GP surgeries across England have begun implementing Jess’s Rule—a patient safety initiative named for Jessica Brady, a young woman whose repeated pleas for help went unanswered until it was too late. The campaign, launched officially in September 2025, has gained renewed momentum this week as 6,170 GP practices receive eye-catching posters urging clinicians to take a "fresh eyes" approach when patients return for a third appointment with unresolved or worsening symptoms.

The story behind Jess’s Rule is as heartbreaking as it is galvanizing. Jessica Brady, a talented satellite engineer, died in December 2020 at the age of 27 after more than 20 appointments with her GP over five months failed to yield a diagnosis, according to BBC. Her symptoms—abdominal pain and weight loss—were alarming, but despite her persistence, Jessica’s illness was not identified until her mother sought private healthcare. By then, Jessica had stage four adenocarcinoma, an advanced cancer for which there were no treatment options. She died just three weeks after her terminal diagnosis.

Jessica’s parents, Andrea and Simon Brady, transformed their grief into a determined campaign for change. Their advocacy, alongside the Jessica Brady CEDAR Trust, led to the creation of Jess’s Rule: a simple but profound policy urging GPs to reconsider their diagnosis, consult colleagues for a second opinion, or arrange further tests if a patient’s symptoms persist or escalate after three visits. The rule is designed to prompt reflection and challenge initial assumptions, especially when a treatment plan isn’t working or symptoms are worsening.

"By supporting clinicians to take a fresh-eyes approach when a patient returns for a third time with the same or worsening symptoms, Jess’s Rule aims to ensure serious illnesses, including cancer, are identified and treated earlier—a goal I remain hopeful will be achieved," said Andrea Brady, as quoted by the BBC. The posters, co-designed with Jessica’s parents and NHS England, are now being displayed in consultation rooms across the country, making the message visible to both doctors and patients.

Health and Social Care Secretary Wes Streeting offered a heartfelt endorsement of the initiative, stating, "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. This is a fitting tribute to Jessica Brady and the tireless campaigning of her parents. Their determination to turn tragedy into lasting change will help protect patients and save lives for years to come." (BBC)

The rollout of Jess’s Rule is much more than a symbolic gesture. It comes with a commitment to additional training for GPs, as noted by the Jessica Brady CEDAR Trust. Many practitioners have pledged to develop further learning resources, especially around diagnosing cancer in younger people—a group disproportionately affected by delays. In fact, research 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 before receiving a cancer diagnosis, compared to just one in five across the general population (Filmogaz).

Dr Claire Fuller, National Medical Director for NHS England, emphasized the practical impact of the rule: "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. 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."

The rule’s core principle—"three strikes and we rethink"—is designed to formalize best practice in general practice. Professor Victoria Tzortziou Brown, Chair of the Royal College of GPs, explained to BBC that Jess’s Rule underlines the importance of taking time to reflect and review a diagnosis if a treatment plan isn’t working. This might involve a more in-depth conversation with the patient, seeking a second opinion, or referring to secondary care. She noted, "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. Jess’s story is an important reminder that sometimes a rare diagnosis could be the right diagnosis."

Dr Sheikh Mateen Ellahi from Elmtree Medical Centre in Stockton-on-Tees added, "It’s so important that our patients feel listened to, and Jess’s Rule gives the public confidence that their health concerns are acted upon. At Elmtree, we recognise that patients are the experts about what feels normal for their body and our clinicians work together with our patients to make joint decisions about care. Jess’s Rule will particularly benefit younger patients and those from ethnic minority backgrounds who often face delays in diagnosis of serious conditions."

The government’s wider efforts to improve patient safety and early diagnosis extend beyond Jess’s Rule. Alongside the new posters, GP surgeries will also receive a letter from the Health Secretary and the National Medical Director of NHS England, reinforcing the importance of the approach. There’s also a £1.1 billion funding boost for primary care, including £160 million to recruit 2,900 more GPs and the rollout of online booking requests to help ease pressure on services and provide more personalized care. According to government sources, patient satisfaction with general practice has improved after a decade of decline, a trend they hope Jess’s Rule will help accelerate.

The rollout of Jess’s Rule is not just about changing protocols—it’s about changing culture. The initiative aims to empower both clinicians and patients, encouraging open dialogue and a willingness to reconsider when things aren’t adding up. As Dr Sheikh Meteen Ellahi put it, "People often notice changes before tests do. This rule, Jess’s Rule, should make the public confident that those concerns will be taken seriously and acted upon early."

For Jessica Brady’s family, the campaign is the realization of her wish that her experience would lead to meaningful change. Andrea Brady reflected, "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."

Jess’s Rule stands as a testament to the power of determined advocacy and the importance of listening—really listening—to patients. In a healthcare system often stretched to its limits, it’s a reminder that sometimes, saving a life starts with simply taking a step back and looking again.