New NHS Initiative Aims to Improve Patient Safety
The NHS is urging doctors in England to reconsider their approach when seeing patients multiple times without a clear diagnosis, particularly if symptoms are worsening. This recommendation is part of a new initiative called Jess’s Rule.
The initiative is named after Jessica Brady, who reached out to her GP over 20 times after falling ill in the summer of 2020. Initially, she was informed that her symptoms were related to long Covid and that she was “too young for cancer.” Tragically, she later succumbed to advanced stage 4 cancer at just 27 years old.
Health Secretary Wes Streeting described her passing as a “preventable and unnecessary tragedy,” highlighting how this new rule is designed to enhance patient safety and allow GPs to identify potentially fatal conditions earlier.
‘Her Body Was Failing Her’
Jessica was a skilled engineer at Airbus, working on satellite designs. According to her mother, Andrea, Jess was in good health prior to the pandemic but began feeling unwell in July 2020, prompting her to contact her GP numerous times over the next several months.
Andrea noted that Jess’s symptoms became more and more debilitating as time progressed. She experienced significant weight loss, night sweats, chronic fatigue, a lingering cough, and swollen lymph nodes. However, her age led many to dismiss the seriousness of her condition.
Despite interacting with six different doctors and having three face-to-face consultations, Jess was not referred to a specialist. “Her body was failing her,” Andrea commented, emphasizing how difficult it was for Jess to advocate for herself in such a frustrating situation.
Ultimately, when Jess’s family sought a private appointment and got her referred to a specialist, it was too late—she received a terminal cancer diagnosis in November and passed away just days before Christmas 2020. The family hopes that Jess’s Rule will highlight the need for GPs to act promptly when patients show signs of deterioration.
“She wanted to make a difference,” Andrea reflected. “Jess felt strongly that she didn’t want this to happen to other people.” Jess understood that her delayed diagnosis had severely limited her treatment options, leaving only palliative care available when she finally learned of her condition.
A New Approach for GPs
Jess’s Rule serves as a reminder to doctors to adopt a “three strikes and rethink” strategy, encouraging them to take action after a patient has had three appointments without improvement. This may include scheduling in-person consultations, ordering additional tests, or seeking a second opinion.
The Royal College of General Practitioners (RCGP) noted that no doctor wants to overlook signs of serious illness like cancer. According to Prof Kamila Hawthorne, chair of the RCGP, diagnosing illnesses can be challenging in primary care because symptoms often overlap with less serious conditions.
Research indicates that younger patients and those from ethnic minority backgrounds often face diagnosis delays due to differing symptoms. The RCGP has collaborated with Jess Brady’s family to create educational resources aimed at increasing awareness of cancer diagnosis in young adults.
The Department of Health acknowledged that while many GP practices already apply the right approach, Jess’s Rule aims to standardize these practices nationwide.
Health Secretary Wes Streeting expressed gratitude to Jessica’s family for their relentless campaigning, stating that their efforts through profound grief may lead to preventing similar tragedies. “Patient safety must be the foundation of the NHS,” he emphasized, asserting that Jess’s Rule aims to ensure every patient receives the thorough and compassionate care they deserve, while also aiding GPs in identifying critical illnesses.
Paul Callaghan, representing Healthwatch England, stressed the importance of swift and consistent implementation of the rule. He also highlighted the necessity for specialist teams to be adequately resourced in anticipation of potentially increased referrals.
