Jess's Rule launched to save lives.
Jess’s Rule is a primary care initiative to encourage GPs teams to rethink a diagnosis if a patient presents three times with the same symptoms or concerns, particularly if symptoms unexpectedly persist, escalate, or remain unexplained. It is led by the Department of Health and Social Care (DHSC) and NHS England and is supported by the Royal College of General Practitioners (RCGP).
Jess’s story
Jessica Brady sadly passed away due to cancer in December 2020 at the age of just 27. In the 5 months leading up to her death, Jess had 20 consultations with her GP practice, and her cancer had not been diagnosed. Jess was then admitted to hospital with stage 4 adenocarcinoma, a type of cancer, and died shortly afterwards. Since then, Jess’s family have bravely campaigned for primary care staff to elevate a patient’s case for review after their third appointment with their practice about a condition or symptom.
Research shows that younger patients and those from ethnic minority backgrounds often face delays in diagnosis of serious conditions, as their symptoms may not match typical presentation patterns seen in older or white patients.
Jess's Rule
Patients with a potentially deadly illness will be diagnosed sooner through the new life-saving patient safety initiative Jess’s Rule, which has been rolled out across the NHS in England.
Jess’s Rule asks GP teams to ‘Reflect, Review and Rethink’ if a patient presents three times with the same or escalating symptoms.
Reflect: Think back on what the patient has said and consider what has changed or been missed. Offer ongoing episodic continuity of care for future direct patient care. If previous consultations have been remote, see the patient face-to-face and conduct a physical examination.
Review: Where underlying uncertainty exists, consider seeking a view from a peer and review any red flags that may suggest another diagnosis, regardless of the patient’s age or demographic.
Rethink: If appropriate, refer onwards for further tests or for specialist input.
