‘Jess’s rule’ posters remind GPs in England to re-examine patients’ symptoms | GPs
Millions of patients in England will be asked this week to ask their GP to think again if they have not received a diagnosis for their symptoms after three appointments.
From Monday, GP practices across the country will use posters to promote Jess’ Rule, a new system aimed at preventing serious illnesses going unnoticed and unnecessary deaths. It is named after Jessica Brady, a 27-year-old who contacted his office 20 times before dying of cancer in 2020.
Jess’ Rule urges family doctors to consider a second opinion, perform an in-person physical exam, or order other tests if a patient has had three appointments for their symptoms but no diagnosis.
Posters announcing Jess’ Rule were sent to all 6,170 GP practices in England. The system was launched in September, but the new posters will boost patient safety by reminding GPs to rethink their initial assumptions, ministers said.
Wes Streeting, the Health Secretary, said: “Every patient deserves to be heard, and every serious illness deserves to be caught early. Jess’ Rule makes this possible, by reminding clinicians to take a fresh look when symptoms persist and by empowering patients to speak up about their care.”
“This is a fitting tribute to Jessica Brady and her parents’ tireless campaign. Their determination to turn tragedy into lasting change will help protect patients and save lives for years to come.”
The posters were designed jointly by Brady’s parents, Andrea and Simon Brady, from NHS England and the Department of Health and Social Care. GP practices will also receive a letter from Streeting and NHS England’s national medical director, Dr Claire Fuller, highlighting the importance of Jess’ rule.
Jessica, an engineer for Airbus, contacted her GP around 20 times in six months before her death in 2020, reporting symptoms including abdominal pain, coughing, vomiting and weight loss.
Due to restrictions during the pandemic, she was offered virtual appointments and prescribed medications, including antibiotics and steroids. She was also told she might have long Covid.
He was eventually diagnosed with cancer that had spread throughout his body, but only after his mother paid for him to see a doctor privately. She died in hospital three weeks later.
Andrea Brady said the Jessica Brady Cedar Trust, the charity set up in her daughter’s name, had been “encouraged” by the positive response from GP practices who had adopted the “three strikes and we think again” approach.
“Many have committed to developing continuing education, while others have written to patients to support the initiative and show their support. This level of commitment has been deeply encouraging,” she said.
Professor Victoria Tzortziou Brown, president of the Royal College of GPs, said Jessica’s story was “an important reminder that sometimes a rare diagnosis can be the right diagnosis”.
