On 23 September 2025 the NHS introduced a new initiative for GPs in England called Jess’s Rule. Also known as the “three strikes and rethink” approach, GPs are being urged to take further action or review and rethink where a patient presents three times with the same or worsening symptoms and a diagnosis cannot be made.
Named after Jessica Brady, a 27-year-old from Stevenage who tragically passed away after her GP surgery failed to diagnose her condition.
In July 2020, Jessica contacted her GP practice with the following symptoms: unintentional weight loss; night sweats; chronic fatigue; a persistent cough and enlarged lymph nodes. She attended her GP on more than 20 occasions over a period of five months; however, no referrals were made.
Jessica decided to attend a private medical appointment and was referred to a specialist. She was then admitted to hospital with stage 4 adenocarcinoma and she passed away just three weeks later in December 2020.
Jessica’s family have campaigned to raise awareness of the important of GPs acting quickly to prevent avoidable deaths.
What is Jess’s Rule?
A new initiative whereby GPs are expected to take further action when:
- A patient has had three appointments with the same or worsening symptoms;
- No substantial diagnosis has been made; and
- A patient’s symptoms are not improving or worsening with current treatment.
When the third strike is reached, GPs are to review and re-consider the patient’s case and take further action, such as considering face to face consultations, ordering further tests, seeking second opinions and making specialist referrals if appropriate.
Delayed diagnosis and misdiagnosis in Early Onset Cancer
Research suggests that when younger patients present with cancer symptoms, such as unexplained weight loss, persistent pain, or unusual lumps they are often misdiagnosed, or their symptoms are dismissed as minor ailments - as discussed in our previous article, Delay in Diagnosis and Misdiagnosis: A growing Concern in Cases of Early Onset Cancer.
Due to age-related bias in diagnosis, younger people like Jessica have been dismissed by medical professionals simply because they appear too young to have a serious illness such as cancer.
The Royal College of General Practitioners (RCGP) were involved in the production of the new guidance and have worked with Jessica’s family to educate GPs on the early diagnosis of cancer in young adults.
Whilst many GPs already apply their own version of “three strikes and rethink”, Jess’s Rule has made this standard practice across all GP practices in England which will help to improve quality of care and save lives by helping to prevent delays and misdiagnosis of serious conditions.
What You Can Do
If you have been affected by a delay in diagnosis or misdiagnosis, you may wish to consider a claim for clinical negligence.
We deal with cases under a Conditional Fee Agreement, also known as a no win no fee.
Our specialist team has vast experience in dealing with accident claims and clinical negligence actions. We believe in using that expertise to ensure we advise and support you in a sympathetic and professional manner, to make pursuing a claim as easy as possible for you and your family. We understand and appreciate the effects of an injury or harm resulting from negligence can be devastating physically, emotionally and financially.
Speak to Lucy Allen by calling 0121 2367388 or by emailing lucy.allen@mfgsolicitors.com.
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