Jesse's Rules to be rolled out among GPs in England: 'Every patient deserves to be heard'

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“Jesse’s rules“It will be promoted nationwide general practitioner Across practices England GPs are being urged to reconsider their patients’ diagnoses starting this week.

The system is named in honor of Jessica Brady, who was contacted by her clinic 20 times before her tragic death in 2020 at the age of 27.

The rules, introduced in September, aim to prevent avoidable deaths and help medical professionals identify serious illnesses, such as cancer, that may be missed.

It particularly prompts GPs to re-evaluate cases where a patient presents three times with the same symptoms but does not receive a diagnosis, or if symptoms worsen.

Under the new guidance, doctors are encouraged to seek a second opinion, perform an in-person physical exam, or order additional diagnostic testing.

Ms Brady’s mother Andrea Brady said the charity set up in her daughter’s name was “encouraged” by the response from primary care to the “three strikes and rethink” approach.

The rule is named after Jessica Brady (left), whose mother Andrea (right) campaigned to change it (Family Handout/PA)

Advertising posters for Jess’s Rule have been distributed to all 6,170 GP surgeries in England.

According to the Department of Health and Social Care, their presentation will urge GPs to challenge initial assumptions to improve patient safety.

Health Secretary Wes Streeting said: “Every patient deserves to be heard and every serious illness detected early. Jesse’s Rules make this possible – reminding clinicians to take another look if symptoms persist and empowering patients to speak out about their care.

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“This is a tribute to the tireless work of Jessica Brady and her parents. Their determination to turn tragedy into lasting change will help protect patients and save lives for years to come.”

The posters were designed by DHSC, NHS England and Jesse’s parents Andrea and Simon Brady.

GP surgeries will also receive letters from Mr Streeting and NHS England national medical director Dr Claire Fuller, stressing the importance of Jess’s rules.

Ms Brady, an engineer at Airbus, contacted her GP around 20 times in the six months before her death in 2020, reporting symptoms including abdominal pain, coughing, vomiting and weight loss.

Due to restrictions during the pandemic, she received virtual appointments and prescription medications, including antibiotics and steroids. She was also told she might have long Covid.

Ms Brady was told she had long Covid and that she was too young for her symptoms to be severe. (Family Handout/PA)

Ms. Brady was eventually diagnosed with cancer that had spread throughout her body, but only after her mother paid her to see a doctor privately. She died in hospital three weeks later.

Andrea Brady said: “Throughout her illness, Jess showed a quiet determination that her experience should lead to meaningful change, which inspired the launch of Jess’s Rules last September. I am incredibly proud of my loving and brave daughter.”

“The Jessica Brady CEDAR Trust, the charity established in Jess’s name, has been encouraged by the response from primary care practitioners to the ‘three strikes and we rethink’ approach.

“Many people have committed to further training, while others have written to patients to endorse the initiative and express their support. This level of engagement is very encouraging.

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“Jesse’s Law posters have now been distributed to all GP surgeries in England and are expected to be displayed in consultation rooms. By supporting clinicians to introduce new treatments when patients experience the same or worsening symptoms for a third time, Jess’s Law aims to ensure that serious diseases, including cancer, are detected and treated earlier – a target I remain hopeful will be achieved.”

GP surgeries are to receive letters from Wes Streeting and NHS England national medical director Dr Claire Fuller highlighting the importance of Jesse's rules — GP surgeries are to receive letters from Wes Streeting and NHS England national medical director Dr Claire Fuller highlighting the importance of Jesse’s rules (PA)

Dr Fuller said: “Encouraging GP teams to challenge diagnoses when it matters most can save lives by avoiding missed or late diagnoses and I would like to thank the Andrea and Simon Brady and Jessica Brady CEDAR Trust for funding the poster and providing important insights.”

Professor Victoria Zorzio Brown, president of the Royal College of General Practitioners, said Ms Brady’s story was “an important reminder that sometimes a rare diagnosis can be the right one”.

She added: “The Jess Rules formalize ‘best practice’ in general practice and highlight the importance of taking time to reflect on and review the diagnosis if a treatment plan does not seem to be working.

“This may mean having more in-depth conversations with patients to see what other factors may be affecting their health, asking colleagues for a second opinion, or referral to secondary care where appropriate.

“Prompt diagnosis leads to better outcomes for patients, but many serious diseases, including many cancers, are difficult to identify in primary care because the symptoms are often similar to other less serious and more common conditions.

“The college is working with the family of Jess Brady and the Jessica Brady CEDAR Trust to develop a learning resource for GPs on diagnosing cancer in young people.”

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Research from the Nuffield Trust and Health Foundation found that half of 16 to 24-year-olds need three or more GP surgeries before they are diagnosed with cancer, compared with one in five of the general population.