Jess's rule posters remind GPs in England to re-examine patients' symptoms

GP practices in England will display 'Jess's rule' posters asking clinicians to reconsider diagnoses after a patient has had three appointments without a diagnosis; the scheme is named after Jessica Brady and was co-designed with her parents and NHS bodies.

GP practices across England are being supplied with posters that promote "Jess's rule", a reminder for clinicians to re-examine patients when symptoms persist. The scheme urges GPs to consider a second opinion, a face-to-face physical examination, or further tests if a patient has had three appointments without a diagnosis. It is named after Jessica Brady, a 27-year-old who contacted her surgery many times before her cancer was diagnosed and who died in 2020. The posters were co-designed with Brady's parents, NHS England and the Department of Health and Social Care, and will be distributed from Monday. Key facts: - Posters have been sent to all 6,170 GP practices in England. - Jess's rule asks clinicians to rethink initial assumptions after three appointments with no diagnosis and to consider a second opinion, a face-to-face exam, or further tests. - The initiative was launched in September and the new posters and letters from Health Secretary Wes Streeting and NHS England's national medical director Dr Claire Fuller are being sent to surgeries. - Jessica Brady contacted her GP surgery about 20 times in six months with symptoms including abdominal pain, coughing, vomiting and weight loss; she was later diagnosed with widespread cancer only after a private consultation and died three weeks later. - Andrea and Simon Brady helped co-design the posters; the Jessica Brady Cedar Trust said many surgeries committed to further training or wrote to patients showing support, and the Royal College of GPs chair called the case a reminder that sometimes a rare diagnosis could be correct. Summary: The campaign is intended to reduce missed serious illnesses by prompting clinicians to review persistent symptoms and to take alternative diagnostic steps. Officials say the posters will reach millions of patients through GP practices and are accompanied by letters stressing the rule's importance. Public and professional responses so far are reported as supportive, but the effect on diagnostic outcomes is undetermined at this time.