Jess’s Rule will affect all patients
Jamie Hawkins, Bethan Finighan and Storm Newton
17:49, 17 Jan 2026
Doctor talking to a patient(Image: GETTY)
A new ‘three strikes’ policy applicable to all patients will be publicised in GP surgeries throughout England starting this week.
Named after 27-year-old Jessica Brady, who reached out to her practice 20 times before her untimely death in 2020, Jess’s Rule is a system that prompts GPs to reconsider their approach if a patient has had three appointments without receiving a diagnosis.
The rule was implemented in September with the aim of preventing avoidable fatalities and assisting doctors in identifying serious illnesses such as cancer.
The rule encourages GPs to reassess situations where patients have had three appointments without a diagnosis or if symptoms have worsened.
They are urged to consider seeking a second opinion, conducting face-to-face physical examinations, or ordering additional tests.
Jessica Brady, who died from cancer aged 27(Image: PA)
Andrea Brady, Jess’s mother, expressed that the charity established in her daughter’s name has been ‘heartened’ by the response from primary care towards the ‘three strikes and rethink’ strategy.
Posters promoting Jess’s Rule have been disseminated to all 6,170 GP practices in England.
These posters, collaboratively designed by DHSC, NHS England, and Jess’s parents, Andrea and Simon Brady, aim to enhance patient safety by encouraging family doctors to question initial assumptions, according to the Department of Health and Social Care, the Manchester Evening News reports.
Health Secretary Wes Streeting commented: “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.”
Jessica, an Airbus engineer, reached out to her GP practice approximately 20 times across a six-month period before her death in 2020, describing symptoms including stomach pain, a persistent cough, sickness and losing weight.
Pandemic restrictions meant she received remote consultations and was given various medicines such as antibiotics and steroids.
Andrea with her daughter Jessica Brady(Image: PA)
Medical professionals also suggested she might be experiencing long Covid.
A cancer diagnosis revealing the disease had metastasised throughout her body only came after her mother funded a private consultation.
Jessica passed away in hospital just three weeks afterwards.
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.
“The Jessica Brady CEDAR Trust, the charity established in Jess’s name, has been heartened by the response from primary care practitioners adopting ‘the Three Strikes and We Rethink’ approach.
“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.
“Jess’s Rule posters have now been distributed to all GP practices in England and are expected to be displayed in consultation rooms. 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.”
Surgeries across the country will also be sent correspondence from Mr Streeting alongside NHS England’s national medical director Dr Claire Fuller, emphasising the significance of Jess’s Rule.
Dr Fuller commented: “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.”
Professor Victoria Tzortziou Brown, chairwoman of the Royal College of GPs, remarked that Ms Brady’s experience “is an important reminder that sometimes a rare diagnosis could be the right diagnosis”.
She continued: “Jess’s Rule formalises ‘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.
“This might mean having a more in-depth conversation with the patient to see what other factors could be impacting their health, asking a colleague for a second opinion, or if appropriate, 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 college has worked with Jess Brady’s family and the Jessica Brady CEDAR Trust to develop learning resources for GPs on diagnosing cancer in younger people.”
A study conducted by Nuffield Trust and the Health Foundation revealed that 50 per cent of individuals aged 16 to 24 needed three or more consultations with their GP practice before receiving a cancer diagnosis, in contrast to just one-in-five people across all age groups.