NEWS: Introduction of Jess’s Rule to Help GPs Avoid Preventable Deaths

GPs in England are being urged to “think again” if they see a sick patient three times without a determined diagnosis, or if their symptoms are worsening

According to the BBC, the NHS is introducing a new initiative, called Jess’s Rule, named after Jessica Brady, who contacted her GP on more than 20 occasions after starting to feel unwell in the summer of 2020.

She was told her symptoms were related to long Covid and that she was “too young for cancer”. She died from advanced stage 4 cancer later that year, aged 27.

Her mum, Andrea, told Radio 4’s Today programme that Jess was a very healthy young woman when the pandemic hit in 2020.

Jessica had been a healthy young woman, but in July 2020 she began to feel unwell and contacted her GP multiple times over the next five months.

Her symptoms included unintentional weight loss, night sweats, a persistent cough, enlarged lymph nodes and chronic fatigue, but these were brushed off due to her young age.

After appointments with six doctors at her GP surgery and three face-to-face consultations, no referral was made to a specialist. By the time Jess’s family arranged an appointment with a private specialist, it was already too late. Jess’s delayed diagnosis meant that she had no treatment options available, only palliative care.

Jess was diagnosed with adenocarcinoma, a terminal diagnosis, and died just three weeks later in December 2020.

Jess’s preventable death led to the introduction of Jess’s Rule which is intended to be a strong reminder to GPs to take a “three strikes and rethink approach”. That means that action should be taken if a patient has attended three appointments with the same symptoms.

This can vary in execution, from arranging face-to-face consultations with patients who would previously have been only spoken to by phone, ordering additional tests, or referring patients to a specialist in the hopes of preventing more avoidable deaths.

Research suggests younger patients and people from ethnic minority backgrounds often face delays before being diagnosed with a serious condition, because their symptoms aren’t the same as those of white or older patients, and due to the fact that many symptoms of serious illnesses can be similar to those of more common conditions with a less serious outcome.

Whilst many GP practices are believed to already use a steadfast approach to ensure the best possible care for patients, Jess’s Rule aims to make this standard practice nationwide.