Medico-legal litigation of UK physiotherapists in relation to cauda equina syndrome: a multimethods study

Abstract

ObjectiveThe aim was to investigate the extent of cauda equina syndrome (CES) litigation and explore the process of medico-legal litigation in relation to physiotherapy in the UK.DesignA multimethods inquiry that followed on from a previously conducted scoping literature review was undertaken to address the aim. This included freedom of information requests and direct communication with relevant stakeholders and organisations.ResultsA total of 2496 CES claims were found in the UK between 2012 and 2020. 51 of these were attributed to physiotherapists. There was little information available to physiotherapists regarding the legal process of litigation and much of this information was not from a physiotherapist’s perspective.ConclusionThis is the first study that has investigated the extent and process of CES litigation in physiotherapy in the UK. The extent of CES litigation appears to be high considering CES is a rare spinal condition. Furthermore, the extent of CES litigation is suspected to be considerably higher than the data reported in this study due to the issues identified in how CES claims are recorded. Finally, there is no clearly articulated, easily accessible information describing the process and support available for physiotherapists in receipt of a legal claim.

The lived experiences of UK physiotherapists involved in Cauda Equina Syndrome litigation. A qualitative study

“…Participants were eligible if they were a qualified physiotherapist who had been involved in CES litigation in the UK. However, to gain a holistic understanding of the phenomenon of interest, previous research indicated the need to understand the experience of UK physiotherapists at risk of CES litigation i.e., those working in advanced roles [ 7 , 8 ]. Furthermore, for context and to aid understanding of the issue, we also needed to speak to a range of stakeholders, who included:…”

“…An interview topic guide ( S1 File ) was used to guide the interview to provide further consistency and to direct the interview by providing a priori topics to be explored in relation to the aim of the study, whilst allowing sufficient flexibility to explore new and unanticipated issues. The interview guide was developed from a review of the literature [ 7 , 8 ] and was refined following piloting and critical discussion with the research team and a patient and public involvement group (PPI). The PPI group included three people living with CES and a physiotherapist who had been involved in a CES litigation case.…”

“…Within a UK context, whilst physiotherapists have possessed professional autonomy for many years the role is rapidly changing with increasing numbers of advanced roles, including advanced practice physiotherapy (APP) and first contact practitioner (FCP) roles, in settings such as emergency departments and Primary Care [ 6 ]. Therefore, more physiotherapists are likely to become a first point of contact for patients who have not been screened by a medic for a serious pathology such as CES, and consequently are becoming increasingly involved in litigation claims [ 7 , 8 ]. Previous research found a total of 2496 CES claims in the UK between 2012–2020 [ 7 , 8 ].…”

“…Therefore, more physiotherapists are likely to become a first point of contact for patients who have not been screened by a medic for a serious pathology such as CES, and consequently are becoming increasingly involved in litigation claims [ 7 , 8 ]. Previous research found a total of 2496 CES claims in the UK between 2012–2020 [ 7 , 8 ]. Of these, 51 were attributed to physiotherapists, however this is likely to be an underestimation due to deficiencies in current reporting methods [ 8 ].…”

“…Previous research found a total of 2496 CES claims in the UK between 2012–2020 [ 7 , 8 ]. Of these, 51 were attributed to physiotherapists, however this is likely to be an underestimation due to deficiencies in current reporting methods [ 8 ].…”