Key takeaways
GIRFT guidance was first introduced in 2023
Guidance aims to improve the ability of healthcare professionals to provide appropriate treatment in cases of suspected CES.
Benefits demonstrated of implementing getting it right first time (GIRFT) guidance
Where GIRFT guidance is followed, hospital admissions for Cauda Equina Syndrome (CES) can be reduced.
Additional benefit: reduced negligence claims
Where clinicians have followed national guidelines, a claim is much less likely.
Research findings show potential benefits to hospitals of implementing GIRFT guidance on cauda equina syndrome (‘CES’).
Guidance on CES was issued by the Getting It Right First Time (‘GIRFT’) programme in 2023. The findings of an independent research project studying the effects of implementing it have recently been published. They suggest that, where the GIRFT guidance is followed, hospital admissions can be reduced.
CES may be described as a spinal surgical emergency. It is a rare condition in which compression of nerves descending from the end of the spinal cord leads to symptoms including bladder dysfunction. It may be amenable to surgical treatment if diagnosed at a sufficiently early stage. Delay in treating it may result in permanent loss of bladder function and other adverse consequences. Cases of alleged delay in diagnosis have spawned many clinical negligence claims.
The GIRFT guidance, ‘National Suspected Cauda Equina Syndrome (CES) Pathway’, was issued in February 2023 with the aim of improving the ability of healthcare professionals to provide appropriate treatment in cases of suspected CES. The guidance includes succinct advice on the symptoms which warrant immediate referral to the nearest facility with emergency MRI provision.
The research findings published recently in the Neuroradiology Journal provide evidence that there are benefits to hospitals of implementing the guidance. According to the article ‘GIRFT guidance reduces cauda equina syndrome related admissions without negatively impacting diagnosis’, the results of the study showed that utilization of the guidance reduced CES-related admissions with no negative effect on the diagnostic yield of emergency MRI scans.
GIRFT’s leadership has expressed delight with the researchers’ findings, confirming the belief that implementing the guidance can be effective in reducing patient harm.
Besides reducing hospital admissions, another potential benefit to be obtained from it would be reduction in the incidence of clinical negligence claims. Where clinicians have followed national guidelines issued by an organisation of GIRFT’s standing, they are most unlikely to be held negligent irrespective of the outcome.
View the GIRFT guidance here.
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