She Was Dismissed 20 Times By Her Doctor

According to new NHS guidelines, general practitioners will need to get a second opinion if they are unable to diagnose a patient after three visits.

The ‘three strikes and rethink’ system comes into effect across England today with the aim of speeding up diagnoses and cutting avoidable deaths.

It comes after worries that an excessive number of people are having their symptoms ignored or disregarded until their illness is too severe to cure.

The policy will be known as Jess’s Rule, in tribute to Jessica Brady, who contacted her GP surgery about 20 times in the six months before her demise from cancer, aged 27.

The Stevenage-based Airbus engineer complained of weight loss, coughing, vomiting, and stomach discomfort but was given virtual appointments and a lot of prescription drugs, including steroids and antibiotics.

She was also told she was suffering from long COVID and that she was too young for her symptoms to be anything serious.

Ms Brady was eventually diagnosed with adenocarcinoma, which had spread throughout her body – but only after her mother paid for her to see a doctor privately.

She was put on oxygen and passed away in the hospital three weeks later, in 2020.

The new initiative tells GPs to think again if, after three appointments, they have been unable to offer a substantiated diagnosis or the patient’s symptoms have escalated.

Although many general practitioners now employ comparable strategies in complicated circumstances, Jess’s Rule will standardise this nationwide.

It was created in cooperation with NHS England and the chair of the Royal College of General Practitioners (RCGP).

The guideline can entail scheduling in-person consultations in the event that prior sessions were conducted remotely, doing comprehensive physical examinations, or requesting further diagnostic testing.

Additionally, it encourages general practitioners to thoroughly examine patient records, get second opinions from colleagues, and, when necessary, think about referring patients to specialists.

Andrea Brady, Jess’s mum, said, ‘Jess lived for just three short weeks following her terminal cancer diagnosis.

‘Despite her shock and devastation, she showed unfailing courage, positivity, dignity, and love.

‘Jess was determined that people should understand how desperately she had tried to advocate for herself and seek a resolution for her declining health.

‘In the bleak weeks following the loss of Jess, I realised it was my duty to continue what she had started.

‘It has taken nearly five years to bring about Jess’s Rule. I would like to dedicate this initiative to all the young people who have been diagnosed too late.

‘It has only been made possible because of the people who have listened—politicians, medics, and nearly half a million who supported the campaign.’

According to research, individuals from ethnic minority origins and younger people frequently experience delays in receiving a diagnosis of dangerous diseases since their symptoms do not mirror those of older or white patients.

A report from the Nuffield Trust and the Health Foundation found that half of 16- to 24-year-olds needed three or more interactions with a healthcare professional from a GP practice before being diagnosed with cancer, compared to one in five across the entire population.

Paul Callaghan, policy manager at patient watchdog Healthwatch England, said Jess’s Rule will come as a ‘relief’ to patients living with the ‘anxiety of worrying symptoms’ but unable to get a diagnosis.

He added, ‘Jess’s Rule will also improve patient safety by ensuring more rapid diagnosis of cancer and other illnesses and provide clarity to those experiencing sickness or ill health.

‘Feedback from the public consistently highlights their frustration with long waits for diagnosis and treatment.

‘It is vital that the rule is implemented quickly and consistently, and people can make informed decisions about their care.

‘It’s also imperative that specialist teams have the resources to deal with potential increases in demand, resulting from increased referrals.’

Every person deserves the same standard of care, regardless of their age or background. Still, research reveals that too many young people and those from ethnic minority backgrounds face delays getting proper diagnoses because their symptoms don’t fit standard patterns doctors expect to see in older, white patients.

Professor Kamila Hawthorne, Chair of the Royal College of GPs, said, ‘No GP will ever want to miss signs of serious illness, such as cancer.

‘Ensuring a timely diagnosis often means better outcomes for patients – but many conditions, including many cancers, are challenging to identify in primary care because the symptoms are often similar to other, less serious and more common conditions.

‘Alternative diagnoses are often more likely, particularly when considering risk factors such as age.

‘If a patient repeatedly presents with the same or similar symptoms, but the treatment plan does not seem to be making them better – or their condition is deteriorating – it is best practice to review the diagnosis and consider alternative approaches.

‘We hope that by formalising this with Jess’s Rule, it will remind GPs to keep this at the forefront of their minds.’

Health secretary Wes Streeting said, ‘Jessica Brady’s death was a preventable and unnecessary tragedy.

‘I want to thank her courageous family, who have campaigned tirelessly through unimaginable grief to ensure Jessica’s legacy helps to save the lives of others.

‘Patient safety must be the bedrock of the NHS, and Jess’ Rule will make sure every patient receives the thorough, compassionate, and safe care that they deserve while supporting our hard-working GPs to catch potentially deadly illnesses.

‘I don’t want any family to endure the pain Jessica’s family has been through.

‘This government will learn from such tragedies and is taking decisive action to improve patient safety.’

Dr Claire Fuller, national medical director at NHS England, said, ‘I am very humbled by the efforts of Andrea and Simon Brady, who have campaigned for this important initiative which will undoubtedly save lives by avoiding missed or delayed diagnoses and ensuring patients receive the right treatment at the right time.’

‘Many clinicians already apply a version of “three strikes and rethink” in their routine practice, but Jess’s Rule formalises this instinctive approach, providing a consistent structure to support reflection and timely action for patients.’

Sadly, GPs are the root of the problem, along with obnoxious receptionists who believe they are the doctor. People have been messed about for ages, and you end up going around in circles.

No doctor should be brushing off their patient; they should be connecting with them. If they had taken Jess’s symptoms seriously, then she may have stood a chance – this is not good enough, and more needs to be done.

I understand that doctors are not God, but if they are truly not sure, they should always seek a second opinion. My own father died of non-Hodgkin lymphoma, first diagnosed as arthritis, and when he really became ill and had to have a blood transfusion at the hospital, he was then diagnosed with this horrible disease; he died 7 weeks later. However, if his doctor had taken more notice, he may have survived.

The patient is never listened to, the healthcare sector is extremely misogynistic, and they expect us to put up and shut up.