A new NHS guideline, named “Jess’s Rule,” is being rolled out across GP practices in England following the tragic death of 27-year-old Jessica Brady, whose cancer was missed despite repeated visits to her doctors.
The initiative urges GPs to take a “three strikes and rethink” approach: if a patient attends three times with the same symptoms and their condition is not improving, doctors must reassess, order further tests, or consider specialist referrals.
Tragedy Behind the Rule
Jessica Brady, an engineer at Airbus from Stevenage, began feeling unwell during the summer of 2020. Despite more than 20 contacts with her GP practice, she was told her symptoms were linked to long Covid and that she was too young to develop cancer.
Her condition worsened, with weight loss, night sweats, extreme fatigue, a persistent cough, and swollen lymph nodes. Still, no referral was made. When her family finally arranged a private consultation, Jessica was diagnosed with stage 4 adenocarcinoma. She died just weeks later, days before Christmas.
Her mother, Andrea Brady, described her daughter as “a healthy, bright young woman” who struggled to be heard. “Jess knew her delayed diagnosis left her with no treatment options. She didn’t want this to happen to anyone else,” she said.
NHS Response
Health Secretary Wes Streeting called Jessica’s death “a preventable tragedy” and said Jess’s Rule would strengthen patient safety. “This will ensure patients receive compassionate and thorough care, while supporting GPs to spot potentially deadly illnesses,” he added.
The Royal College of General Practitioners (RCGP), which helped draft the guidance, acknowledged the challenges of spotting cancer in young adults, as their symptoms often resemble common illnesses. Chair Prof Kamila Hawthorne said:
“If a patient returns several times with the same concerns and isn’t improving, it is best practice to revisit the diagnosis and consider alternatives.”
Wider Concerns
Research shows younger patients and ethnic minority groups often face delays in serious diagnoses, partly due to symptoms not fitting the typical profile. Jess’s Rule aims to address these disparities by making early action a standard expectation.
Healthwatch England welcomed the rule but warned that hospitals must be prepared for more referrals. “It’s vital specialist teams have the resources to manage additional demand,” said Paul Callaghan.
A Lasting Legacy
While Jess’s Rule is not legislation, it serves as a national reminder to GPs to act promptly when a patient’s health is deteriorating. The Brady family hopes it will save lives and ensure Jessica’s suffering leads to meaningful change.
“She wanted to make a difference,” Andrea said. “Now, her story will help protect others.”
