In September 2025, NHS England launched a new patient safety guideline called Jess’s Rule , designed to help catch serious illnesses such as cancer sooner and reduce the risk of misdiagnosis.

Jess’s Rule is named in memory of Jessica “Jess” Brady, a talented engineer at Airbus, who contacted her GP on more than 20 occasions after starting to feel unwell in the summer of 2020. Jess suffered from weight loss, night sweats, chronic fatigue, a persistent cough and enlarged lymph nodes. She was repeatedly told that her symptoms were related to long Covid and that she was “too young for cancer”.

Jess’s family sought a private consultation, which led to a referral to a specialist, but by then it was too late. In November 2020, she was diagnosed with terminal adenocarcinoma, a cancer affecting the glandular cells lining the organs. Tragically, Jess passed away just three weeks later at the age of 27, only days before Christmas.

Jess’s Rule brings in a “three strikes and rethink ” approach for GPs in England. Under this new guidance, if a patient has attended three appointments without a clear diagnosis or their symptoms have worsened, doctors are urged to reassess and act. The initiative aims to ensure that no patient leaves without answers, offering protection and hope where it was once missing.

Key points of the new initiative

• If a patient has attended three appointments for the same symptoms - or if concerns are increasing - without a clear diagnosis, or if the current treatment isn’t effective, the GP must pause and reconsider the case.
• This may include a face-to-face consultation (if earlier appointments were remote), ordering further tests, seeking a second opinion, or referring the patient to a specialist.
• The goal is to reduce delays, particularly for younger people and ethnic minorities, who research shows often wait longer or are less likely to have their concerns taken seriously when symptoms are unclear or unusual.

Jess's Rule is not a law, but a strong reminder to GPs to take action after a patient attends three appointments with the same symptoms, to prevent avoidable deaths. Jess’s Rule formalises what some GP practices already do informally in complex cases but the idea is to make it standard practice across England, so that patient safety is more consistent.

Designed in collaboration with the chair of Royal College of General Practitioners (RCGP) and NHS England, Jess’s Rule will help to catch serious conditions earlier and support GPs with guidelines that bolster their clinical judgement, while encouraging them to reflect, review and rethink if they are uncertain about a patient’s condition.

The RCGP have said that if a patient repeatedly presents with the same or similar symptoms, but the treatment plan does not seem to be making them better, or their condition is deteriorating, it is best practice to review the diagnosis and consider alternative approaches.

Organisations like the RCGP, the Teenage Cancer Trust, Healthwatch, and the Oral Health Foundation have welcomed the move. However, there are concerns about ensuring specialist services have enough capacity to handle increased referrals, so that when GPs act more often on suspicion, the system can support those investigations.

Preventing delayed treatment

This new NHS initiative honours Jess’s memory, but more importantly, it aims to ensure that no one else has to suffer a preventable tragedy because their concerns were discounted.

Sadly, at Switalskis we see first-hand the devastating impact when patients and families are not listened to. Therefore, we welcome Jess’s Rule and we hope that it will improve patient safety and save lives.

If you or a loved one has experienced delayed treatment or substandard medical care, we’re here to help. Our expert medical negligence team can guide you in seeking answers and securing the compensation needed to move forward.