Jess’s Rule asks GPs to take a ‘fresh eyes’ approach and think again if, after 3 appointments, they have been unable to offer a patient a substantiated diagnosis or their symptoms have escalated.
All GP surgeries in England will receive Jess’s Rule posters from this week, displaying the safety drive to GPs, primary care staff and patients in thousands of consultation rooms. The initiative, announced in September 2025, is named in honour of Jessica Brady, who died of cancer in December 2020 at the age of 27. It will help avoid tragic, preventable deaths as GPs are supported to catch potentially deadly illnesses sooner.
In the 5 months leading up to her death, Jessica had more than 20 appointments at her GP surgery but was eventually forced to seek private healthcare. She was later diagnosed with stage 4 adenocarcinoma - a type of cancer - which was so advanced there was no available treatment, and she died in hospital 3 weeks later.
Jess’s Rule is the result of years of campaigning undertaken by Jess’s parents to transform a tragedy into lasting patient safety change.
Displaying Jess’s Rule posters in consultation rooms will boost patient safety by prompting doctors to revisit patient records, challenge initial assumptions and remain alert to warning signs that might otherwise be missed.
The rollout to all 6,170 GP surgeries in England showcases the government’s commitment to protecting patients, saving lives and preventing unnecessary tragedies.
Jess’s mum Andrea Brady said: "Jess was eventually diagnosed with stage 4 cancer after contacting her GP surgery on 20 occasions over a 5-month period. Devastatingly, she died just 3 weeks later. 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 ‘3 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."
Health and Social Care Secretary Wes Streeting said: "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."
The new Jess’s Rule posters were co-designed by the Department of Health and Social Care, NHS England and Jess’s parents, Andrea and Simon Brady. They will make sure every patient’s voice is heard and that GPs have the support they need to detect serious illness before it is too late.
Alongside the posters, GP surgeries will also receive a letter from the Health Secretary and the National Medical Director of NHS England, Claire Fuller, reinforcing the importance of this approach. The letter will ask GPs to display the poster in consultation rooms or staff areas to ensure the messaging around Jess’s Rule is visible to all teams.
Dr Claire Fuller, National Medical Director for NHS England, said: "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, ‘3 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."
Professor Victoria Tzortziou Brown, Chair of the Royal College of GPs, said: "No GP ever wants to miss signs of serious illness, such as cancer. 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. Jess’s story is an important reminder that sometimes a rare diagnosis could be the right diagnosis."
Jess’s Rule will particularly benefit younger patients and those from ethnic minority backgrounds who often face delays in diagnosis of serious conditions.
A report from the Nuffield Trust and the Health Foundation on cancer diagnosis in younger people and people of minority ethnicities, found that half of 16 to 24 year olds required 3 or more interactions with a healthcare professional from a GP practice before being diagnosed with cancer, compared to one in 5 people across the whole population.
In practice, Jess’s Rule will encourage GPs to:
- arrange face-to-face consultations if previous appointments were remote
- conduct thorough physical examinations
- order additional diagnostic tests
- seek second opinions from colleagues
