NHS Urged to Improve Cauda Equina Care

Helen Neville
Helen Neville
Partner, Medical Negligence

A national plan to help patients with symptoms of Cauda Equina get timely treatment should be put in place, a new report has said.

The Healthcare Safety Investigation Branch (HSIB) has urged the NHS to take steps to improve the care given to people with symptoms of spinal nerve compression.

According to a new report by the body, cases of Cauda Equina Syndrome (CES) aren’t always being diagnosed and people aren’t getting the treatment they need on time because there isn’t a “clear national pathway” for managing the condition.

This, it said, is because healthcare providers are taking different approaches across the country and not following the same timescales.

The HSIB believes clearer policies and guidance would improve the chances of Cauda Equina Syndrome being identified and patients getting the treatment they need on time.

Getting timely treatment is vitally important because delays can have lifelong consequences, both physical and mental, including paralysis, incontinence and psychological issues.

Cauda Equina Syndrome has several warning signs, including lower back pain, abnormal bowel function and weakness in both legs. It is crucial anyone with these symptoms gets medical attention and treatment as soon as possible.

But it is just as important for healthcare professionals to recognise these symptoms, make the connection with Cauda Equina Syndrome, and refer their patients for the appropriate tests without delay.

What Else Has the HSIB Recommended?

The HSIB has also called on the National Institute for Health and Care Excellence (NICE) to update its guidance on lower back pain to include details of the symptoms of Cauda Equina Syndrome and how to manage it.

NICE guidance does not cover the evaluation of CES; it currently only provides guidance on low back pain and sciatica. This leads to variation in practice and no standardised diagnostic criteria and management pathways for patients with suspected CES.

It also recommended the creation of a ‘decision-making tool’ to help identify patients who need an immediate MRI scan if they are suspected to have Cauda Equina Syndrome, as well as new guidance on how “urgent” and “emergency” requests for MRI scans should be defined and then prioritised.

Concerns Raised after Delay in Patient's Treatment

The HSIB recommendations came after a case concerning Cauda Equina Syndrome prompted an investigation into the care patients receive.

The case concerned a woman who presented with symptoms of Cauda Equina Syndrome but had to wait four days for an MRI scan, and then a further ten hours following the scan to be transferred to a specialist spinal centre. She then faced further delays in getting the spinal decompression surgery she urgently needed.

Her experience provoked the HSIB to take a wider look at the consistency of care for patients who present with potential red flag symptoms for Cauda Equina Syndrome and investigate the reasons behind the delay in diagnosis and treatment.

I am very happy that we have had the HSIB undertake this investigation and make a call for this long-awaited national guidance and dedicated NHS pathway to reduce the delays in diagnosis.

Cauda Equina syndrome is a rare, but incredibly serious and time sensitive condition. The psychological and physical impact is life-changing and affects patients and their families.

I have watched clients go through the pain and suffering of what was avoidable harm. I have been there to support them and obtain the compensation they deserve to help get them the treatment and support they so greatly need.

Helen Neville, Partner and Law Society Accredited Clinical Negligence specialist
xray showing cauda equina

How We Can Help You

If you’ve been left with problems and symptoms because you believe the symptoms of Cauda Equina Syndrome were not identified or treated quickly enough, or because you have suffered a surgical error, our specialist Medical Negligence Solicitors can help you.

If we take on your case, we will investigate what happened and how it has affected your life. We will work together to reach a settlement that reflects your specific needs and priorities.

Claiming compensation for medical negligence can make a huge difference in helping you rebuild your life; it means you can access the vital treatment and long-term support you need.

At the same time, it can shine a light on wider issues that may be putting patients at risk, and encourage the NHS to make positive changes to stop similar mistakes happening again to other people.

We offer a free claims assessment, so you can speak to our friendly experts with no obligation.

Our aim is to get you started on the road to recovery without delay, so let us take care of the difficult tasks, and help you get the justice you deserve.


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