'Jess's Rule' Campaign Urges English GPs to Re-examine Patient Symptoms

New Campaign Launched to Enhance Diagnostic Accuracy in General Practice

A significant new patient safety campaign, dubbed 'Jess's Rule', is now active across all 6,170 General Practitioner (GP) practices in England. The initiative, officially launched in September 2025, aims to reduce diagnostic errors by prompting healthcare professionals to re-examine patients' symptoms, particularly when conditions remain unresolved after multiple consultations.

The campaign's core principle, 'Three Strikes and We Rethink', encourages GPs to adopt a 'fresh eyes' approach. This involves a three-step process: 'reflect, review, and rethink' if a patient presents for a third time with the same or escalating symptoms without a substantiated diagnosis.

The Tragic Inspiration Behind 'Jess's Rule'

'Jess's Rule' is named in memory of Jessica Brady, a talented satellite engineer who tragically died in December 2020 at the age of 27 from stage four adenocarcinoma. Jessica's cancer went undiagnosed despite her attending over 20 GP appointments in the five months leading up to her death, where she reported symptoms such as abdominal pain, weight loss, coughing, and vomiting.

Her parents, Andrea and Simon Brady, transformed their grief into a determined campaign for change, advocating for a system that would prevent similar tragedies. Andrea Brady stated, 'Throughout her illness, Jess showed a quiet determination that her experience should lead to meaningful change, inspiring the launch of Jess's Rule in September last year.'

Key Directives for General Practitioners

Under 'Jess's Rule', GPs are encouraged to take several proactive steps when a patient's symptoms persist or worsen:

• Reflect: Reconsider the patient's history and identify any missed or changed information. If previous consultations were remote, a face-to-face physical examination should be offered.
• Review: Seek a second opinion from colleagues and re-evaluate any 'red flags' that might suggest an alternative diagnosis, irrespective of the patient's age or demographic.
• Rethink: If appropriate, escalate the case by arranging further diagnostic tests or referring the patient to a specialist.

Health Secretary Wes Streeting emphasized the importance of the campaign, stating, '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.'

Addressing Diagnostic Errors and Patient Safety

The campaign is supported by the Department of Health and Social Care (DHSC), NHS England, and the Royal College of General Practitioners (RCGP). Posters co-designed with Jessica's parents are being displayed in consultation rooms across England, and GP surgeries will also receive a letter from the Health Secretary and the National Medical Director of NHS England, Dr Claire Fuller, reinforcing the initiative's significance.

Research indicates the prevalence of diagnostic errors in primary care. One study found that a 'missed diagnostic opportunity' (MDO) occurred in 4.3% of GP consultations, with 40% of these leading to moderate or severe patient harm. Another review identified MDO occurrences in 61.4% of consultations, with 54% rated as likely to cause moderate or severe harm. 'Jess's Rule' particularly aims to benefit younger patients and those from ethnic minority backgrounds, who often experience greater delays in diagnosing serious conditions.