New training for GPs as woman’s cancer symptoms dismissed 20 times

The new guidance for GPs is Jess’s Rule, a “three strikes and we rethink” approach launched in England on 23 September 2025 by NHS England and the Department of Health and Social Care, with the backing of the Royal College of GPs.

It asks GP teams to reflect, review and rethink when a patient returns for a third time with the same or worsening symptoms and no clear diagnosis, and to consider further tests, a referral or a fresh opinion. The rule is named after Jessica Brady, who died of cancer aged 27 in December 2020 after more than 20 contacts with her GP practice over five months without her cancer being diagnosed.

Jess’s Rule is guidance rather than law, but it sets out what good practice should look like. If you or a loved one saw a GP repeatedly without your symptoms being properly investigated, and a serious illness was diagnosed late as a result, you may have grounds for a medical negligence claim.

Jessica Brady, aged 27, died just three weeks after being admitted to hospital with stage four adenocarcinoma following a privately sought consultation.

She had contacted her GPs more than 20 times in the preceding five months with symptoms of abdominal pain, vomiting and coughing. She was not once sent for further investigations or tests to determine the cause of her concerns.

Jessica’s illness was during Covid-19 lockdowns, and she had to fight to get a face-to-face appointment with her GP. Despite her continual and increasing worries about her symptoms, she was only offered virtual appointments and told it was ‘nothing serious’.

Jessica’s family are campaigning and working with the Department of Health for a change in procedures to escalate treatment following three GP visits.

A spokesman for the Department of Health has stated: “It is clear opportunities to diagnose Jessica sooner were missed, and the secretary of state has met her parents on two occasions to discuss how to prevent similar tragedies from happening in future.”

The Royal College of GPs is looking at new guidance that will introduce the notion of “three strikes and rethink,” encouraging the GP to seek a referral or further advice from a specialist.

It is hoped that this training will result in an increase in timely diagnosis and, ultimately, better outcomes for patients.

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