Simon and I meet frequently to discuss progress on Jess’s Law. This week we will meet twice, once with The Department of Health and Social Care to discuss the progress The Royal College of General Practitioners is making to devise new awareness training for GPs and on another occasion to meet with a working party who is reviewing future technologies to flag patients who return to their GP with unresolved symptoms. I also have a telephone call planned with the main lead creating the Primary Care Safety Strategy. However, the main thing we talk about is the interpretation of Jess’s Law and the need for it.
When Steve Barclay was Secretary of State for Health, he kindly met with us, in person, twice. His initial response to Jess’s Law was to say that we did not need legislation for something that should be happening anyway. This was my response.
“In explaining the lack of necessity to make a law for something that is patently obvious, you used the analogy of safely landing an aircraft. Of course, you are absolutely right, if the correct systems are in place such regulation is irrelevant and unnecessary. However, most laws are simply legislation formalising points which are simple common-sense values and actions. Although all cars are fitted with seat belts and awareness campaigns demonstrate they save lives, the need to wear one is enshrined in law. For forty years we no longer assume people will demonstrate prudence and travel safely in cars. Jess’s Law may appear to be stating the obvious, but our campaign demonstrates this is sadly not the case. Countless accounts, shared with us, show clearly that GPs are not proactive in referring patients, presenting with the same symptom or condition. Most commonly, the Drs responsible for primary care make unsubstantiated diagnoses to reassure patients. The result is an eventual diagnosis presenting with stage 3 or 4 cancer. If the mantra for training Doctors ‘3 strikes and they’re in’ has been lost in recent years, the response to our campaign indisputably shows medical practitioners would like it reinstated.”
Recently NHS England suggested a reworking of Jess’s Law “If you are seen 3 times for the same thing and are not improving and do not have a diagnosis – then think again and consider a referral.” This was my response,
“The sticking point with the proposed reworking of Jess’s Law is that "if you are seen 3 times for the same thing and are not improving and do not have a diagnosis – then think again and consider a referral,” is “and do not have a diagnosis”. Our findings have shown that GPs are very good at offering an ‘unsubstantiated’ diagnosis as a means of placating a patient. Jess' was Long Covid, but there was no evidence for this (she had not tested positive with Covid). Other examples are stress, a pulled muscle, migraine, irritable bowel, indigestion. allergies – the list is endless. Giving unsubstantiated diagnoses is dangerous because it wastes time. So, Jess’s Law cannot just come into play if there is no diagnosis – there is rarely no diagnosis. Forgive me, but the reworking is also a bit woolly. The key thing here is, a patient returning after 3 times, despite a diagnosis, with unresolved symptoms.”
Every single day we nudge, we clarify, we act. We are grateful for the people who work with us but mostly we are grateful to you. Without you none of this would be possible. Thank you so much for supporting Jess’s Law and remembering our darling girl.