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GPs to adopt 'Jess's rule' and re-evaluate patients after third appointment

The Guardian

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September 23, 2025

GPs in England are to adopt a “three strikes and rethink” approach to patients whose illness they have not been able to diagnose despite multiple appointments in the rollout of an initiative known as “Jess's rule”.

- Tobi Thomas

It is named after Jessica Brady, who died aged 27 of stage four cancer in December 2020 after experiencing symptoms such as abdominal pain, coughing, vomiting and weight loss for six months.

Before her death, Brady had contacted her GP surgery more than 20 times but was repeatedly wrongly diagnosed with long Covid and due to coronavirus restrictions she never had a face-to-face appointment.

After attending a private consultation Brady was diagnosed with stage four adenocarcinoma. She died three weeks later in hospital.

According to Jess's rule, GPs will have to reevaluate a patient's case if their symptoms have escalated or they are unable to offer a credible diagnosis. The rule was developed by NHS England and the Royal College of General Practitioners (RCGP).

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