A major new patient safety initiative, Jess's Rule, has been rolled out across all 6,170 GP practices in England. The campaign is named after 27-year-old engineer Jessica Brady, who tragically died from advanced cancer in 2020 after 20 undiagnosed GP visits. The rule is designed to prompt family doctors to take swift action when patients return repeatedly with unresolved symptoms.
The initiative is formally backed by the Department of Health and Social Care (DHSC), NHS England, and the Royal College of General Practitioners (RCGP). A key component is the distribution of posters to every GP surgery to reinforce a "three strikes and rethink" approach. This formalises good clinical practice, encouraging GPs to reflect, review, and rethink when a patient's condition remains unclear, especially after three appointments with no diagnosis or with worsening symptoms.
Under Jess's Rule, if a patient presents on three separate occasions with persistent or escalating symptoms, GPs are strongly encouraged to take specific steps. These actions include seeking a second clinical opinion, undertaking a face-to-face physical examination, ordering additional diagnostic tests, or referring onward to secondary care. While the rule does not alter the legal clinical framework, it serves as an essential prompt in busy primary care settings, reinforcing good diagnostic vigilance.
First launched in September 2025 and now being widely promoted in January 2026, the initiative aligns with the UK's broader 10-Year Health Plan to improve disease detection and reduce health inequalities. Health Secretary Wes Streeting stated that “every patient deserves to be heard and every serious illness deserves to be caught early.” The policy is supported by research, including an analysis by the Nuffield Trust and the Health Foundation, which found that about half of young cancer patients (aged 16–24) required three or more GP interactions before a diagnosis.
GP leaders stress that the rule is not a mandate for unnecessary testing but encourages clinicians to listen carefully and reflect on the full clinical picture. It is particularly valuable in cases involving remote consultations, limited continuity of care, or symptoms that evolve over time—all factors that can complicate diagnosis.
While patient advocates welcome the cultural shift towards early detection and shared decision-making, they stress that the initiative must be supported by adequate GP capacity, longer consultation times, and better access to diagnostics. They caution that prompts are most effective when paired with necessary workforce support and diagnostic pathways to manage any resulting increase in referrals. Ultimately, Jess's Rule signals a vital cultural shift: patients with persistent concerns must be heard, valued, and carefully reassessed, ensuring primary care functions as an effective first line of defence against late diagnosis.
