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Amy Walker
A new system urging doctors to “think again” if they are unable to pin down a diagnosis after seeing a patient three times – named Jess’s Rule – is to be advertised in every GP surgery in England from next week.
The NHS initiative is named after Jessica Brady, who died from advanced stage four cancer in 2020 aged 27.
Before her eventual diagnosis, Jess had contacted her GP on more than 20 occasions after feeling unwell, but was told her symptoms were related to long Covid and that she was “too young for cancer”.
Her mother, Andrea Brady, welcomed the government rollout of the posters. She told BBC Breakfast: “We still need to trust our doctors but trust ourselves as well.”
Under the patient safety initiative, GPs are asked to take a “fresh eyes” approach if they have been unable to offer a patient a substantiated diagnosis or their symptoms have escalated after three appointments.
Jess, an engineer at Airbus, became ill in June 2020.
Andrea said her family initially assumed it was something minor, “but that wasn’t what happened for Jess”.
Her symptoms, which included unexplained weight loss, night sweats and vomiting, then worsened.
“It was very, very painful… to see the impact on Jess not just physically but the toll it was taking on her mentally,” said Andrea.
Jess had contact with six different doctors at her GP surgery and three face-to-face consultations with a family doctor, but no referral to a specialist was made.
Her family then arranged a private appointment and she was referred to a specialist, who gave Jess a terminal cancer diagnosis of adenocarcinoma – cancer of the glands that line the organs – in November.
She died three weeks later, just days before Christmas 2020.
The government said the consultation room posters would improve patient safety by prompting doctors to “revisit patient records, challenge initial assumptions and remain alert to warning signs that might otherwise be missed”.
Health Secretary Wes Streeting said: “Every patient deserves to be heard, and every serious illness deserves to be caught early.
“Jess’s Rule makes that possible – reminding clinicians to take a fresh look when symptoms persist, and empowering patients to speak up about their care.”
Andrea said the family wanted to follow what Jess had “really wanted to start when she was diagnosed, which was to create some positive change”.
“It’s taken five years but to know now that Jess’s rule is out there and happening and is being received really positively and proactively by primary care colleagues is really, really important,” she added.
She said the rule was a “two-way thing” intended to benefit both patients and GPs.
The posters were designed by Jess’s parents Andrea and Simon in partnership with NHS England and the Department of Health, and funded by the Jessica Brady Cedar Trust established in her honour.
Dr Claire Fuller, NHS England’s national medical director, said: “Encouraging GP teams to challenge a diagnosis when it matters most could save lives by avoiding missed or late diagnoses.”
