In December 2020, Jessica Brady sadly passed away from stage 4 adenocarcinoma, cancer of the glands after a terminal diagnosis.
Jessica contacted her GP on more than 20 occasions in 2020 with symptoms of unintentional weight loss, night sweats, chronic fatigue, a persistent cough and enlarged lymph nodes but her symptoms were dismissed.
Jessica was told several times that her symptoms were related to long Covid, or she was told that she was too young to have a serious illness like cancer.
Jessica was only diagnosed after a private appointment with a specialist in November 2020 and she died a few weeks later in December 2020.
Jess’ rule has been implemented as a primary care initiative and reminder to GPs to take a ‘three strikes and rethink approach.’ This means that if a patient has presented to a GP three or more times with the same symptoms, which are not improving, then further action should be taken, such as arranging a face to face appointment with the patient if they have previously had a telephone appointment, ordering more tests, obtaining a second opinion from a colleague or referring the patient to a specialist.
GPs are asked to ‘reflect, review and rethink’ the diagnosis that may have been made.
This includes:
- Reflect – think back on what the patient has said and consider what has changed or been missed.
- Review – consider seeking a review from a colleague or review any red flag symptoms that may suggest a different diagnosis regardless or the age or demographic of the patient.
- Rethink – refer onwards for further tests or for specialist input.
More detail about the implementation of Jess’ rule can be found here.
It is hoped that Jess’ rule will support GP teams to manage patients with unclear symptoms to avoid late or missed diagnoses and give people a better chance of survival and recovery.
Kirsty Dakin, Associate Solicitor at MDS and Specialist Medical Negligence Solicitor, said ‘The loss of Jessica and her story is tragic. It is important that these missed opportunities are being identified and acted upon to stop this happening again.’
