Patient Safety Medical Negligence
Jess's Rule
Three strikes and we rethink.
Jess's rule is a primary care initiative in English Healthcare to encourage GP teams to rethink a diagnosis if a Patient presents three times with the same symptoms or concerns, particularly if the symptoms unexpectedly persist, escalate or remain unexplained. Jessica Brady passed away due to cancer in December 2020 at the age of 27. In the five months leading up to her death, Jess had 20 Consultations with her GP practice and her cancer had not been diagnosed. Jess was then admitted to hospital with Stage 4 Adeno Carcinoma and passed shortly afterwards. Since then, Jess's family have campaigned for primary care staff to elevate the Patient’s case for review after their third appointment with their practice about a condition or symptom.
Jess's Rule.
Jess's Rule asks GP teams to reflect, review and rethink if a Patient presents three times with the same or escalating symptoms.
Reflect
Think back on what the Patient has said and consider what has changed or been missed. Offer ongoing episodic continuity of care for future direct Patient care. If previous consultations have been remote, see the Patient face to face and conduct a physical examination.
Review
Where underlying uncertainty exists, consider seeking a view from a peer and review any red flags that may suggest another diagnosis, regardless of that Patients or demographic.
Rethink
If appropriate, refer onwards for further tests or specialist input.
How is Jess's Rule implemented in England.
Many GP teams already apply a version of three strikes and rethink in their routine practice. Jess's rule formalises this instinctive approach, providing a consistent structure to support reflection and timely action.
No additional training or materials are required for its implementation.
Jess's Rule is designed to align with existing good practice and professional Judgement.
For more detailed insights into how the Patient Safety Act 2023 impacts you and how Whelan Law can support you, please visit our Patient Safety Rights Legal Advice https://www.whelanlaw.ie/news/medical-negligence-and-patient-safety/