Implementation of Jess's Rule 

Jess's Rule is a primary care initiative to encourage GPs teams to rethink a diagnosis if a patient presents three times with the same symptoms or concerns, particularly if symptoms unexpectedly persist, escalate, or remain unexplained. It is led by the Department of Health and Social Care (DHSC) and NHS England and is supported by the Royal College of General Practitioners (RCGP).

Bay Medical Group are committed to keeping our patients safe, which is why we are adopting the new NHS initiative known as Jess's Rule. This national patient safety rule was created in memory of Jessica Brady, who sadly died of cancer after repeatedly seeking help without her symptoms being fully reassessed.

Jess's Rule ensures that if a patient visits us three times with the same ongoing or worsening symptoms, our clinicians will take a fresh look, including reviewing previous consultations, arranging a face to face examination if needed, discussing with colleagues and considering further tests or referrals to rule out serious illness.

This 'three strikes and rethink' approach is being introduced across all GP practices in England to help catch serious conditions like cancer earlier and prevent avoidable harm, and we are proud to put it into practice at Bay Medical Group

Clinicians  are invited to consider the following approaches in such a scenario

Reflect

Consider what has happened so far and offer a face to face appointment if appropriate, to allow a physical examination if this has not been carried out earlier or symptoms have got worse 

Review

Consider discussing with other Bay Medical Group colleagues, consider requesting further diagnostic tests to help rule out underlying conditions. Also consider whether any ‘red flags’ are ‘hiding in plain sight’.

Rethink

Consider the use of advice and guidance for a fresh perspective on the symptoms or in some cases a referral to a specialist team.

Published: Feb 3, 2026