In response to the tragic death of 27-year-old Jessica Brady in 2020, who passed away from stage 4 adenocarcinoma following over 20 GP appointments over a 6 month period with no diagnosis, NHS England and the Royal College of General Practitioners have introduced a vital new patient safety initiative: Jess’s Rule.
Jess’s Rule
Announced in September 2025, Jess’s Rule introduces a “three strikes and rethink” approach for GP practices in England. It encourages clinicians to pause and reassess when a patient:
- Presents three times with the same or worsening symptoms, or
- Remains undiagnosed after multiple consultations.
This approach is designed to reduce missed or delayed diagnoses, particularly in patients who don’t fit the typical risk profile for serious conditions, like cancer.
Jess’s Rule encourages GPs to take a “Three Step Approach” when assessing patients with repeat consultations:
- Reflect – Consider what may have changed or been overlooked, especially if earlier consultations were remote.
- Review – Revisit the diagnosis, consult with colleagues, and recheck for red flags, regardless of the patient’s age or background.
- Rethink – If necessary, escalate the case: order further investigations, refer to a specialist, or arrange a face-to-face examination.
Why It Matters
Jess’s Rule reinforces a vital message: persistent, unexplained, or worsening symptoms should never be dismissed, regardless of a patient’s age, background, or how typical their case may seem. It challenges assumptions and encourages clinicians to take repeat presentations seriously.
By prompting a review after three consultations without a diagnosis or improvement, the rule aims to reduce delays in diagnosing serious conditions, particularly in younger patients or those who don’t fit the usual risk profiles for illnesses such as;
- cancer
- autoimmune diseases,
- neurological conditions,
- gynaecological conditions
- gastrointestinal disorders.
For patients, Jess’s Rule provides a clear framework to reference if they feel their concerns haven’t been properly addressed after multiple visits. It empowers individuals to ask whether their case has been reconsidered and whether further investigation is warranted.
The initiative also highlights the importance of continuity of care. It encourages patients to raise concerns, request face-to-face appointments when symptoms persist, and keep a detailed record of their visits, symptoms, and any escalation in their condition.
How Ison Harrison Can Help
If you or someone you know has experienced a delay in diagnosis or a failure to act in the light of repeated presentations, our specialist clinical negligence solicitors at Ison Harrison are here to support you. We understand the emotional and practical challenges in pursuing a clinical negligence claim and will guide you through every step, ensuring access to appropriate medical advice and seeking the answers and compensation you deserve.
Contact us today for confidential advice and compassionate support.
