Getting it Right First Time (GIRFT) National Suspected Cauda Equina Syndrome (CES) Pathway

Published in 2019, the Getting it Right First Time (GIRFT) National Specialty Report for Spinal Services reviewed emerging themes, and made recommendations for regional and national implementation based on visits to 127 spinal units. One opportunity found during visits was that many patients with suspected Cauda Equina Syndrome (CES) were not being referred for onward care in line with agreed treatment protocols. CES is a serious spinal presentation, which, if not diagnosed and treated swiftly, can result in lifechanging injury. 23% of litigated claims for spinal surgery in England relate to CES (based on GIRFT’s assessment of litigated claims in England between 2013/15 -15/16). This document – and the pathway it supports – aims to provide clinicians working in all care settings, with the ability to effectively diagnose and care for patients presenting with suspected Cauda Equina Syndrome. Our thanks go to all the health professionals involved in this document, from inception to completion. GIRFT cannot succeed without the backing of clinicians, managers and all of us involved in delivering patient care.