New ‘Three Appointment Rule’ Launched in All GP Surgeries in England

A new initiative known as Jess’s Rule is set to be implemented in all general practitioner (GP) surgeries across England this week. The rule aims to address the critical issue of undiagnosed medical conditions by prompting healthcare professionals to reconsider cases where patients have attended three appointments without a diagnosis. This initiative is named after Jessica Brady, who tragically passed away in 2020 after reaching out to her GP surgery approximately 20 times.

The introduction of Jess’s Rule comes as part of a broader effort to prevent avoidable deaths and improve early detection of serious conditions, including cancer. The initiative encourages doctors to reassess patients’ situations if they return three times with persistent or worsening symptoms. Healthcare professionals are advised to seek second opinions, conduct face-to-face assessments, or request additional diagnostic tests.

Andrea Brady, Jessica’s mother, expressed her gratitude for the support from primary care services. She emphasized the positive reception of this “three strikes and rethink” approach, highlighting the importance of its implementation. Promotional materials, including posters detailing Jess’s Rule, have been distributed to all 6,170 GP surgeries across the country.

According to the Department of Health and Social Care, the display of these posters will enhance patient safety by encouraging GPs to rethink their initial assessments. Health Secretary Wes Streeting stated, “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.”

The collaborative effort in creating the posters involved the Department of Health and Social Care, NHS England, and Jessica’s parents, Andrea and Simon Brady. They aim to ensure that GP practices receive communications emphasizing the critical importance of Jess’s Rule.

Jessica Brady’s experience was marked by repeated attempts to consult her GP regarding severe symptoms, including abdominal pain, coughing, vomiting, and significant weight loss. Due to pandemic restrictions, she was primarily limited to remote consultations and received various medications, including antibiotics and steroids. Unfortunately, it was only after a private consultation that she received a devastating cancer diagnosis, just weeks before her untimely passing.

Reflecting on her daughter’s legacy, Andrea Brady remarked, “Throughout her illness, Jess showed a quiet determination that her experience should lead to meaningful change.” She noted the engagement from primary care practitioners as “profoundly encouraging,” with many committing to further training and outreach to patients in support of the initiative.

Dr. Claire Fuller, national medical director of NHS England, remarked, “Encouraging GP teams to challenge a diagnosis when it matters most could save lives by avoiding missed or late diagnoses.” This sentiment aligns with the overarching goal of Jess’s Rule—to foster timely and accurate diagnoses that can lead to better health outcomes for patients.

The Royal College of GPs has also voiced support for the initiative, with chairwoman Professor Victoria Tzortziou Brown stating that Ms. Brady’s story serves as a crucial reminder about the importance of thorough examinations in general practice. She emphasized the need for healthcare professionals to take the time to reflect on diagnoses and engage in open conversations with patients.

Recent studies, including a joint report from the Nuffield Trust and the Health Foundation, highlight a concerning trend: half of young patients aged 16 to 24 required three or more appointments before receiving a cancer diagnosis, compared with one in five across all age groups. This statistic underscores the urgency of implementing Jess’s Rule to reduce the likelihood of delayed diagnoses.

As Jess’s Rule takes effect across England, the hope remains that this initiative will lead to improved early detection of serious health conditions, ultimately saving lives and promoting better patient care in the future.