GPs will be told to take a “three strikes and rethink” approach to diagnosing patients under a new rule to prevent avoidable deaths.
The government’s new patient safety initiative, Jess’s Rule, will ask GPs in England to reconsider diagnoses if patients have had three appointments with no substantial diagnosis, or a patient’s condition worsens.
While the Department of Health and Social Care stated that many GPs use a similar approach, the rule now makes it standard practice, aiming to ensure everyone receives the same standard of health care.
It’s named after Jessica Brady, a 27-year-old engineer who died from cancer in 2020, despite having had repeated GP appointments in the months leading up to her death.
Over six months, she contacted her surgery around 20 times with symptoms including abdominal pain, coughing, vomiting and weight loss.
Due to coronavirus lockdown restrictions, Brady was offered virtual appointments, given numerous medications, including antibiotics and steroids, and ultimately told she had long Covid and was too young for her symptoms to be anything serious.
After her mother paid for a private doctor, Ms Brady was later diagnosed with stage 4 adenocarcinoma.
She was placed on oxygen and died in hospital three weeks later.
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Andrea Brady said after the new rule was announced that despite “her shock and devastation” at the diagnosis, her daughter “showed unfailing courage, positivity, dignity, and love”.
“In the bleak weeks following the loss of Jess, I realised it was my duty to continue what she had started,” she added.
“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.”
Designed in collaboration with the Chair of Royal College of General Practitioners (RCGP) and NHS England, doctors will now be encouraged to consider a second opinion, see people face-to-face for physical examinations, order more tests and make specialist referrals where appropriate.
In a statement about the new rule, Health Secretary Wes Streeting said Ms Brady’s death “was a preventable and unnecessary tragedy”.
He added: “I don’t want any family to endure the pain Jessica’s family have been through. This government will learn from such tragedies and is taking decisive action to improve patient safety.”
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RCGP Chair Professor Kamila Hawthorne said that “it is best practice to review the diagnosis and consider alternative approaches,” and added: “We hope that by formalising this with Jess’s Rule, it will remind GPs to keep this at the forefront of their minds.”
