The new rule is being implemented in Stoke-on-Trent, Staffordshire and the rest of England
GP surgeries across the UK must now adopt the “three appointment” rule
GPs are being made to bring in a new ‘three appointment rule’. Jess’ Rule is a new law being implemented in England across the NHS from today (September 23) to help diagnose illnesses sooner and prevent avoidable deaths.
It is named after Jessica Brady who died from cancer aged 27 in 2020 after having around 20 GP appointments where her symptoms were not recognised or diagnosed correctly.
GPs will now have to take a ‘three strikes and rethink approach’ with all their patients, which means that if after three appointments, they have been unable to offer a substantiated diagnosis, or the patient’s symptoms have escalated, they must ‘rethink’ the approach.
While many GP practices already use similar approaches in complex cases, Jess’s Rule will make this standard practice across the country, aiming to reduce health inequalities and ensuring everyone – no matter their age or background – receives the same high standard of care.
Designed in collaboration with the Chair of Royal College of General Practitioners (RCGP) and NHS England, Jess’ Rule will help to catch serious conditions earlier and support GPs with guidelines that bolster their clinical judgment, while encouraging them to reflect, review and rethink if they are uncertain about a patients’ condition.
Jess’ mum Andrea Brady said: “Jess lived for just three short weeks following her terminal cancer diagnosis. Despite her shock and devastation, she showed unfailing courage, positivity, dignity, and love. Jess was determined that people should understand how desperately she had tried to advocate for herself and seek a resolution for her declining health.
“In the bleak weeks following the loss of Jess, I realised it was my duty to continue what she had started. It has taken nearly five years to bring about Jess’ Rule. I would like to dedicate this initiative to all the young people who have been diagnosed too late.
“It has only been made possible because of the people who have listened – politicians, medics, and the nearly half a million who supported the campaign.”
Jessica Brady was just 27 when she died from cancer(Image: Andrea Brady)
In the five months leading up to her death, Jess had more than 20 appointments with her GP practice but eventually had to seek private healthcare. She was later diagnosed with stage 4 adenocarcinoma. With such an advanced disease there was no available treatment. She was admitted into hospital where she died three weeks later.
Health and Social Care Secretary Wes Streeting said: “Jessica Brady’s death was a preventable and unnecessary tragedy. I want to thank her courageous family, who have campaigned tirelessly through unimaginable grief to ensure Jessica’s legacy helps to save the lives of others.
“Patient safety must be the bedrock of the NHS, and Jess’ Rule will make sure every patient receives the thorough, compassionate, and safe care that they deserve, while supporting our hard-working GPs to catch potentially deadly illnesses.
“I don’t want any family to endure the pain Jessica’s family have been through. This government will learn from such tragedies and is taking decisive action to improve patient safety.”
Dr Claire Fuller, National Medical Director at NHS England says: “I am very humbled by the efforts of Andrea and Simon Brady, who have campaigned for this important initiative which will undoubtedly save lives by avoiding missed or delayed diagnoses and ensuring patients receive the right treatment at the right time.
“Many clinicians already apply a version of “three strikes and rethink” in their routine practice, but Jess’s Rule formalises this instinctive approach, providing a consistent structure to support reflection and timely action for patients.”
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