By Julia Banim,Martin Bagot

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Jessica Brady was just 27 when she died, three weeks after receiving a devastating diagnosis. Tragically, her grave condition had gone unnoticed by GPs approximately 20 times over a six-month period, with Jess being told she was ‘too young’ to be suffering from anything serious. By the time she finally received her stage 4 cancer diagnosis, it was too late. Worryingly, Jessica’s story is far from unusual. A report from the Nuffield Trust and the Health Foundation discovered that half of 16 to 24-year-olds require at least three GP appointments before receiving a cancer diagnosis, compared to one in five across the entire population. With this in mind, the NHS has now rolled out Jess’ Law, intended to ensure other young patients don’t suffer the same sort of dismissal. And Jessica’s brave mum Andrea Brady has been at the very heart of the campaign. Andrea said: “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 the nearly half a million who supported the campaign.” Jess’s Rule highlights the need to remain alert to symptoms that might point towards serious conditions, regardless of the patient’s age or ethnicity. Designed in collaboration with the Chair of Royal College of General Practitioners (RCGP) and NHS England, it’s hoped this new legislation will help to catch serious conditions earlier, while encouraging GPs to reflect, review and rethink if they are uncertain about their patients’ condition. These new rules were discussed today by health correspondent Dominic Hughes on BBC Breakfast, where Jessica had previously appeared as a guest. Dominic told viewers: “Under Jess’s Rule, GPs will be asked to think again if, after three appointments, they haven’t been able to offer a firm diagnosis or the patient’s symptoms have escalated. “That might mean arranging a face-to-face consultation, a thorough physical examination, or more diagnostic tests. “GPs will also be encouraged to seek second opinions from colleagues, review patient records, and consider specialist referrals. The hope is that Jess’s Rule will save lives and help catch serious conditions earlier, particularly in young people.” Jessica was a talented young engineer for Airbus, with a bright career ahead of her. Footage aired on BBC Breakfast today shows her expressing admiration for her fellow women in STEM, enthusing: “The first thing that struck me here when I came to Airbus was just how many women are in STEM and all around, and how inspiring they are.” Sadly, Jessica’s life took a very different turn in the summer of 2020, when she began to feel unwell, struggling with symptoms such as abdominal pain, coughing, vomiting and weight loss. Over the six-month period that followed, she contacted her GP surgery approximately 20 times. This was a time when COVID-19 restrictions were in place, and so Jessica was offered virtual appointments. She was also given various medications, including antibiotics and steroids. GPs told Jessica that she was suffering from long Covid, reassuring her that she was too young for her symptoms to be anything more serious. This turned out to be heartbreakingly inaccurate. Eventually, mum Andrea paid for her daughter to be seen privately. Only then was she finally diagnosed with stage 4 adenocarcinoma, a type of cancer that starts in the glands that line the organs. By this point, the terminal cancer had spread throughout Jessica’s body. She was placed on oxygen and passed away in the hospital just three weeks later, in December 2020. Andrea shared: “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.” Going forward, with Jess’ Rule in place, family doctors throughout England must now take a “three strikes and rethink approach” after three appointments. GPs have also been asked to “think again” if, after three appointments, they are still unable to give a diagnosis or the patient’s symptoms have worsened. After Jess’ Law was announced this week, Dr Claire Fuller, England’s National Medical Director, 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.” It’s believed Jess’s Rule may support GPs when providing continuity of care for patients with persistent health concerns. For example, this could involve arranging face-to-face consultations if prior appointments were remote, carrying out thorough physical examinations, or ordering additional diagnostic tests. Professor Kamila Hawthorne, Chair of the Royal College of GPs, stated: “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.” The RCGP has also helped create an educational toolkit for GPs regarding the early diagnosis of cancer in young adults. Paul Callaghan, policy manager at Healthwatch England, said: “The news that Jess’s Rule is being introduced into the NHS will come as a relief to those living with the anxiety of worrying symptoms, but are unable to get a diagnosis. “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. 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.” Do you have a story to share? Email me at julia.banim@reachplc.com