Jess’s Rule is a national primary care initiative requiring GP teams to rethink diagnoses when patients present three times with the same or escalating symptoms. The rule formalises good practice that teams already follow and builds on GMC Good Medical Practice principles.

The rule follows a three-step framework:

Reflect

• Consider what has changed or been missed
• Provide continuity of care for future appointments
• Conduct face-to-face examination if previous consultations were remote

Review

• Seek peer input where uncertainty exists
• Reassess red flags regardless of age/demographics
• Challenge assumptions about diagnosis

Rethink

• Refer for investigation or specialist input when appropriate
• Re-evaluate why symptoms remain unresolved
• Consider alternative diagnoses

Actions for General Practice

• No additional training required as this formalises existing good practice
• Review resources available to support primary care cancer in NCL and national guidelines