Jess’ Rule, a system which calls for GPs to think again if a patient has had three appointments for their symptoms with no diagnosis, is being brought into all practices across England from this week
A new ‘three strikes’ policy affecting all patients will be brought into GP surgeries throughout England from this week. It will give patients the option to ask doctors to think again if they keep presenting with the same symptoms.
Named after 27-year-old Jessica Brady, who reached out to her practice 20 times before her untimely death in 2020, Jess’ Rule is a system that encourages family doctors to reconsider if a patient has had three appointments without a diagnosis. The rule was implemented in September to prevent avoidable fatalities and assist medical professionals in not overlooking serious illnesses such as cancer.
The rule prompts GPs to reassess when dealing with patients who have had three appointments without a diagnosis, or if symptoms have worsened. They are urged to contemplate seeking a second opinion, conducting face-to-face physical examinations with patients, or ordering additional tests.
Jess’ mother, Andrea Brady, said that the charity established in her daughter’s name has been ‘heartened’ by the response from primary care to the ‘three strikes and rethink’ strategy. Posters promoting Jess’ Rule have now been distributed to all 6,170 GP practices in England to raise awareness of the new scheme.
These posters, collaboratively designed by DHSC, NHS England, and Jess’s parents Andrea and Simon Brady, aim to enhance patient safety by encouraging family doctors to question initial assumptions, according to the Department of Health and Social Care, according to the Manchester Evening News. Speaking on the initiative, Health Secretary Wes Streeting said: “Every patient deserves to be heard, and every serious illness deserves to be caught early.
“Jess’s Rule makes that possible — reminding clinicians to take a fresh look when symptoms persist, and empowering patients to speak up about their care. This is a fitting tribute to Jessica Brady and the tireless campaigning of her parents; their determination to turn tragedy into lasting change will help protect patients and save lives for years to come.”
Jess, an Airbus engineer, reached out to her GP practice approximately 20 times across six months before her death in 2020, describing symptoms including stomach pain, coughing, being sick and losing weight. Because of pandemic restrictions, she was offered remote consultations and given treatments such as antibiotics and steroids; she was also told she might be experiencing long Covid.
A cancer diagnosis revealing the disease had spread throughout her body only came after her mother funded a private consultation. Jess passed away in hospital three weeks afterwards.
Andrea admitted there were some really tough times in the final days of Jess’ life, but she pushed through: “Throughout her illness, Jess showed a quiet determination that her experience should lead to meaningful change, inspiring the launch of Jess’s Rule in September last year. I am so incredibly proud of my caring and courageous daughter.
“The Jessica Brady CEDAR Trust, the charity established in Jess’ name, has been heartened by the response from primary care practitioners adopting ‘the Three Strikes and We Rethink’ approach. Many have committed to developing further training, while others have written to patients to endorse the initiative and show their support; this level of engagement has been profoundly encouraging.”
GP surgeries will also receive letters and emails from both Streeting and NHS England’s national medical director Dr Claire Fuller to emphasise the significance of Jess’s Rule. Dr Fuller said: “Encouraging GP teams to challenge a diagnosis when it matters most could save lives by avoiding missed or late diagnoses, and I’d like to thank Andrea and Simon Brady and the Jessica Brady CEDAR Trust for funding and providing their important insights to develop the posters.”
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