Jess’s Rule asks GPs to take a fresh look at a patient’s symptoms if they have seen them 3 times with the same problem, if their symptoms are getting worse, or if there is still no clear diagnosis A diagnosis is when a medical professional like a doctor has said you have a certain illness or condition. .
Doctors should reflect, review and rethink what might be causing the symptoms and arrange for more tests or refer the patient to a specialist.
Jess’s Rule helps make sure patients are listened to, and that ongoing or worsening symptoms are not missed.
About Jess's Rule
Introduced in 2025 and rolled out to doctors surgeries in 2026, Jess’s Rule asks GPs to think again if after 3 appointments, they have been unable to offer a patient a diagnosis, effective treatment or their symptoms have got worse. Doctors are encouraged to use a fresh eyes approach and reflect, review, rethink if a treatment plan is not working for the patient.
About Jess
Jess worked as a satellite engineer and was a healthy, active young adult and a non-smoker who did not drink alcohol. In June 2020, she contacted her GP with abdominal pain and was prescribed antibiotics for a presumed UTI via a virtual
consultation
Consultation is finding out what people think about something.
, without an examination or urine test.
Over the following months, her symptoms had escalated; she developed extreme fatigue, a persistent cough, acute post-nasal drip with blood in her mucus, recurrent fevers, lymphadenopathy, vomiting, and noticeable weight loss, despite 20 appointments with her GP practice.
Following a private, self-funded referral, she was then admitted to hospital with stage 4 adenocarcinoma and died three weeks after her diagnosis.
In December of 2020, Jessica Brady passed away at the age of 27, following a five-month illness.
The importance of Jess's Rule across GP practices
Since then, Jess’s family have campaigned for primary care staff to elevate a patient’s case for review after their third appointment with their practice about a persistent condition or symptom. In this video Dr Ayo Oladele breaks down Jess's Rule and the importance of it being used in GP practices.
Three strikes and we rethink
If, after three consultations, a patient’s condition remains unresolved, or their symptoms are getting worse and/or they have no substantiated diagnosis, their case should be escalated for review.
Jess’s Rule asks GP teams to ‘reflect, review and rethink’ if a patient presents three times with the same condition, or their symptoms are getting worse, their case should be escalated for review.
Reflect: Looking back on what the patient has previously said and consider if anything has changed or been missed. If previous consultations have been remote, the patient should be seen face-to-face and for a physical examination.
Review: Where there is underlying uncertainty, doctors should consider seeking a view from a peer, and review any red flags that may suggest another diagnosis.
Rethink: If appropriate, refer onwards for further tests or for specialist input.
Detecting deterioration
The introduction of Jess's Rule to GPs in England is to help improve care, and promote early cancer detection - especially in younger adults who may not fit the typical risk profile.
This rule helps remind doctors to take a fresh look when a patients symptoms continue. And this also empowers patients to speak up about their care.
Support from a learning disability nurse
Get the support you need when accessing healthcare services.