Jess’s Rule: A simple reminder that could save lives

As claimant healthcare lawyers, we spend our working lives alongside families whose loved ones have been harmed by avoidable medical mistakes. Again and again, we see the same theme: warning signs were present, sometimes for hours or even days, but they were not acted upon. That is where Jess’s Rule comes in.

What is Jess’s Rule?

Jess’s Rule is a new NHS initiative to encourage GPs to “think again” if they see a patient three times with no clear diagnosis or worsening symptoms.

Jess’s Rule stems from the experience of Jessica Brady, when in 2020 her symptoms of weight loss, chronic fatigue, persistent cough and enlarged lymph nodes were not considered to be serious due to her age. After attending her GP practice repeatedly for five months, it was only after a private appointment that resulted in a referral to a specialist that her diagnosis of adenocarcinoma was made, by which point the cancer was beyond treatment. Jess sadly died three weeks after her diagnosis. Her concerns were dismissed because she was considered to be “too young” to have a serious illness. Jess was 27.

Consistent attendance over a prolonged period with “ongoing symptoms” but no clear diagnosis and no referral to a specialist for further investigation means risking the long-term health of the patient. Escalation and further investigation are essential.

Why is this so important?

In medical negligence claims, we frequently see how “normalising” each warning sign leads to tragedy. A doctor may assume that rising pain levels are within normal limits or that “watching and waiting” is appropriate because no single factor feels severe enough.

This is human nature — we all want to believe things are fine. But the cost of this normalcy bias is measured in brain injuries, stillbirths, sepsis, strokes, and lost lives. Jess’s Rule is a practical tool to cut through that hesitation.

Jess’s Rule is currently aimed at General Practitioners, but should apply across the healthcare sector. It is relevant to doctors, nurses, midwives, allied health professionals, and anyone working with patients. It gives staff a simple framework to feel confident about raising concerns. It reassures families that they are being heard when multiple issues arise. It provides a clear benchmark of what safe practice should look like.

From a legal perspective, Jess’s Rule matters because it highlights where care falls below a safe standard. If a patient presents three times with the same issues or symptoms that are worsening, and no action is taken, it becomes difficult to defend. More importantly, it is evidence that harm was preventable.

In our medical negligence cases, we often sit across the table from families who have lost loved ones, parents whose babies should be starting school, but instead are living with catastrophic injury or who are no longer alive. Their stories nearly always feature repeated concerns that were not joined up. Jess’s Rule is about joining those dots before harm occurs.

The likelihood is that this will have an impact on specialist clinical teams, who will notice an increase in referrals and will require additional resources to deal with those referrals, thereby putting further pressure on the NHS.

The takeaway

Jess’s Rule is not complicated. It does not require new equipment, expensive systems, or endless training. It is a human reminder: if you have seen a patient three times with the same issues and they are not getting better, think again.

For families, it offers hope that avoidable harm can be prevented. For healthcare professionals, it is a tool that empowers safe, decisive care. And for lawyers like us, it represents the heartbreaking line between what should have been and what tragically was.

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