31/01/2026
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).
Jessica Brady passed away due to cancer in December 2020 at the age of 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 and passed shortly afterwards. Since then, Jess’s family have 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.
*Jess’s Rule: Three Strikes and We Rethink*
If you come to see us three times with the same symptoms or concerns, especially if they continue, get worse, or have no clear explanation, it is a sign for us to take a closer look.
Reflect – We will think back over what you have told us. Has anything changed, or could something have been missed? We will make sure you get ongoing care, and if previous appointments were online, we may ask to see you in person for a full check-up.
Review – If there is still uncertainty, we may ask a colleague for their view and check for any warning signs that could suggest a different cause, no matter your age or background.
Rethink – If needed, we will arrange further tests or refer you to a specialist so you get the care you need.
Three visits are not just a number. They are a signal to pause, review carefully, and make sure nothing is overlooked.
