Bolt Burdon Kemp is committed to improving the lives of those affected by Cauda Equina Syndrome and similar conditions.
What is CES and why does the pathway matter?
CES (Cauda Equina Syndrome) is a spinal surgical emergency that can lead to lower limb paralysis and loss of bowel, bladder and sexual function. Cauda Equina Syndrome requires immediate medical attention to prevent permanent damage.
The GIRFT (Getting it Right First Time) National Suspected Cauda Equina Syndrome (CES) Pathway was introduced in February 2023 and is designed to reduce the delays in diagnosis and treatment for patients presenting with CES.
Proper implementation of the pathway is vital as early diagnosis and treatment are crucial for a better outcome. Not only are the impacts of CES devastating for the individual but failure to identify and treat CES is also costing the NHS millions each year in compensation claims.
How extensively has the GIRFT Pathway been implemented?
At the end of 2023, we wrote to NHS Trusts across England regarding the implementation of the GIRFT (Getting it Right First Time) National Suspected Cauda Equina Syndrome (CES) Pathway.
The responses we have received have confirmed our concerns that, despite being launched over a year ago the vast majority of trusts have still not implemented the GIRFT pathway.
The responses
As of March 2024, we received 67 responses from NHS trusts across England. Out of the responses we received, 7 were not relevant.
Out of the relevant responses we received, just 20% of trusts had implemented the pathway, 18% had not yet but planned to do so in the future and 62% had not implemented the pathway nor did they plan to.
Of those who responded almost 40% specifically highlighted the lack of 24-hour access to MRI machines as a reason that they could not implement this strategy as well as cost and resourcing pressures.
Our study highlights the lack of implementation of the GIRFT pathway and the urgent need for the Government and the NHS to take action on this to prevent any further delays to diagnosis and treatment.
Our call for full implementation of the GIRFT Pathway
We know that full implementation of the GIRFT pathway is vital to ensuring early diagnosis of CES. That is why we are working with our charity partner Cauda Equina Spinal Cord Injury (CESCI) group to ask the Secretary of State for Health and Social Care to:
- Write to all trusts to request they implement the strategy.
- Provide financial support for those trusts that do not yet have the resources to provide 24-hour MRI support.
- Meet with BBK and our charity partner Cauda Equina Spinal Cord Injury (CESCI) group to discuss the importance of the pathway and other challenges facing this community.
You can see a copy of our letter here.
How can you help?
We know this is a very important issue for so many of you who are affected by CES and whose symptoms would have been spotted more promptly had this Pathway been implemented in your local area. If you’d like to support the campaign, to improve awareness of CES and avoid delays in future diagnoses of CES, please support us by:
- Writing to your MP to ask them to raise this with the Secretary of State for Health and Social Care
- Sharing and interacting with our social media posts about our letter to the Secretary of State
- Sharing this campaign with your family and friends and asking them to take action as well!
If you would like to write your Member of Parliament, you can find their details using this website. We also have a suggested template below:
Dear (Your MP – you can find who your MP is using this link)
I am writing as (someone diagnosed with /a family member/a friend of someone diagnosed with) Cauda Equina Syndrome (CES).
CES is a spinal surgical emergency that can lead to lower limb paralysis and loss of bowel, bladder and sexual function. Cauda Equina Syndrome requires immediate medical attention to prevent permanent damage. Early diagnosis and treatment are crucial for a better outcome. Not only are the impacts of CES devastating for the individual but failure to identify and treat CES is also costing the NHS millions each year in compensation claims.
(You can insert your personal experience here if you wish to do so)
In February 2023 NHS England launched its GIRFT (Getting it Right First Time) National Suspected Cauda Equina Syndrome (CES) Pathway. At the end of 2023, Bolt Burdon Kemp LLP and CESCI submitted freedom of information requests to trusts across NHS England. The responses they received confirmed our concerns that, despite being launched over a year ago the vast majority of NHS trusts have still not implemented the GIRFT pathway.
Out of the responses received, just 20% of trusts had implemented the pathway, 18% had not yet but planned to do so in the future and 62% have not implemented the pathway nor do they plan to.
Of those who responded, almost 40% highlighted the lack of 24-hour access to MRI machines as a reason that they could not implement this strategy as well as cost and resourcing pressures.
I am therefore asking that you:
- Write to the Secretary of State for Health and Social Care to contact all NHS trusts and request they implement the strategy.
- Ask the Chancellor to offer financial support for those trusts that do not yet have the resources to provide 24-hour MRI support.
- Write to our local NHS trust to ask if they have implemented the strategy.
- [OPTIONAL: Meet with me so you can understand the impact this condition can have.]
Thank you in advance for your help.
Best wishes.
