A new policy known as Jess’s Rule is being introduced to improve the early diagnosis of serious illnesses in children and young people. Named in memory of Jessica Brady, a 27-year-old who tragically died after her cancer went undiagnosed despite contacting her GP on more than 20 occasions after starting to feel unwell in the summer of 2020. This rule represents a vital change in how primary care responds to persistent, unexplained symptoms.
What is Jess’s Rule?
Jess’s Rule requires GPs to take further action when a young person presents multiple times with the same unexplained symptoms. This action may include arranging diagnostic tests, referring the patient to a specialist, or seeking a second opinion. The aim is to prevent repeated concerns being dismissed or attributed to other causes without thorough investigation. Crucially, it ensures that persistence of symptoms triggers a clinical response, rather than being overlooked.
Addressing a systemic gap
Young people often face barriers in accessing timely diagnoses. Symptoms such as fatigue, pain, or weight loss are sometimes misinterpreted as stress-related or behavioural issues, leading to delayed intervention. In Jess’s case, she had unintentionally lost quite a lot of weight, had night sweats, chronic fatigue, a persistent cough and very enlarged lymph nodes. However, because of her age, it was considered that there wasn’t anything wrong and no referral to a specialist was made. After feeling unheard by her GP, Jess’s family decided to arrange a private referral to a specialist, but by the time she was diagnosed with cancer it was too late and she sadly died three weeks later.
Jess’s Rule seeks to address this by:
- Asking the GP to think again, if after three appointments they have been unable to offer a substantial diagnosis, or the patient’s symptoms have escalated.
- Helping reduce disparities in how people’s health concerns are managed, no matter their age or background.
- Reassuring families that their concerns are valid and will be acted upon.
Changing the culture in primary care and improving patient safety
The introduction of Jess’s Rule reflects a wider cultural shift in the NHS towards more proactive, patient-focused care. It encourages GPs to view repeat presentations as a clinical warning sign. The rule promotes better communication and continuity of care, which are key elements in improving outcomes for young patients.
We regularly see the devastating consequences when warning signs are missed, especially in cases involving children and teenagers. Tragically, many of these outcomes could have been avoided if earlier action had been taken after the first or second GP visit. Jess’s rule will be introduced nationally through guidance issued by the NHS and incorporated into protocols used in GP surgeries.
The rule reinforces what should already be best practice. It sets an expectation that repeated presentations should not be ignored, helping to protect patients from harm.
It is hoped that Jess’s Rule will strengthen trust between families and healthcare professionals by ensuring that persistent concerns lead to timely investigation. Whilst there are always concerns around implementation; by embedding this principle in general practice, it is one step forward in improving patient safety and reducing preventable harm.
How we can help
Claire Leslie has extensive expertise supporting patients and loved ones whose delay in diagnosis has had a catastrophic impact in their lives. We have a deep understanding of delayed diagnosis and treatment claims and can help anyone with concerns around the care they or their loved one received. To speak to a member of our team call us on 0800 0448488 or fill in our contact form here so we can get in touch with you at a time convenient for you.
