The new initiative will ask GPs to think again if, after three appointments, they have been unable to offer a substantiated diagnosis, or the patient's symptoms have escalated.
While many GP practices already use similar approaches in complex cases, Jess's Rule will make this standard practice across the country, aiming to reduce health inequalities and ensuring everyone receives the same high standard of care.
Jess's Rule, which was designed in collaboration with the Royal College of General Practitioners and NHS England, will help to catch serious conditions earlier and support GPs with guidelines that bolster their clinical judgment, while encouraging them to reflect, review and rethink if they are uncertain about a patient's condition.
It also encourages GPs to review patient records comprehensively, seek second opinions from colleagues, and consider specialist referrals when appropriate.
Jess's Rule emphasises the need to remain alert to symptoms that might suggest serious conditions, regardless of a patient's age or ethnicity, thereby reducing health inequalities.
Wes Streeting, health and social care secretary, said: ‘Patient safety must be the bedrock of the NHS, and Jess' Rule will make sure every patient receives the thorough, compassionate, and safe care that they deserve, while supporting our hard-working GPs to catch potentially deadly illnesses.
‘I don't want any family to endure the pain Jessica's family have been through. This government will learn from such tragedies and is taking decisive action to improve patient safety.'
The initiative builds on the recent rollout of Martha's Rule to every acute hospital in England, which empowers patients, families, and carers to request urgent clinical reviews if they are concerned about deteriorating conditions not being adequately addressed.
Reaction
Dr Claire Fuller, national medical director at NHS England, said: ‘I am very humbled by the efforts of Andrea and Simon Brady, who have campaigned for this important initiative which will undoubtedly save lives by avoiding missed or delayed diagnoses and ensuring patients receive the right treatment at the right time.
‘Many clinicians already apply a version of "three strikes and rethink" in their routine practice, but Jess's Rule formalises this instinctive approach, providing a consistent structure to support reflection and timely action for patients.'
Professor Kamila Hawthorne, chair of the Royal College of GPs, said: ‘No GP will ever want to miss signs of serious illness, such as cancer. Ensuring a timely diagnosis often means better outcomes for patients - but many conditions, including many cancers, are challenging to identify in primary care because the symptoms are often similar to other, less serious and more common conditions. Alternative diagnoses are often more likely, particularly when considering risk factors such as age.
‘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. We hope that by formalising this with Jess's Rule, it will remind GPs to keep this at the forefront of their minds. The College has also worked with Jess Brady's family and the Jessica Brady CEDAR Trust to develop an educational resource for GPs on the early diagnosis of cancer in young adults, based around the principles of Jess's Rule.'
