Background: Cauda equina syndrome (CES) is a spinal emergency. Over half of known cases first present to primary care for initial assessment. In February 2023, the Getting It Right First Time (GIRFT) national programme launched new CES guidelines, which included an important change in practice: a new urgent referral route.

Aim: This study aims to explore the awareness and use of the GIRFT guidelines in a primary care setting in England.

Design and setting: A cross-sectional online survey was used to collect data from primary care clinicians working across England.

Method: Using purposive sampling, the survey was shared with primary care clinicians across England and conducted between 21-10-2024 and 24-12-2024. The RE-AIM framework underpinned the survey design. Descriptive analysis was employed to interpret frequency and Likert data.

Results: A total of 515 responses were received from across all 42 integrated care boards in England. Of the 515 participants, 452 (88%) were aware of a CES guideline or pathway, with 297/515 (58%) being aware of the GIRFT guidelines. Two-thirds had access to a local CES pathway (n = 304/452, 67%). Nearly all clinicians highlighted that consulting either a local CES pathway or national guidelines supported their clinical decision making.

Conclusion: This is the first study to investigate the awareness and utilisation of the GIRFT guidelines in primary care across England. The use of locally agreed CES pathways was shown to increase adherence to their recommendations in primary care. These findings suggest that using up-to-date local CES pathways can increase adherence to the GIRFT guidelines.

Keywords: CES; cauda equina syndrome; clinical practice guideline; getting it right first time (GIRFT); knowledge mobilisation; primary care.

© 2025 The Author(s). Musculoskeletal Care published by John Wiley & Sons Ltd.

背景：背景:

马尾综合征（CES）是一种脊髓紧急情况。超过一半已知的病例首先在初级保健中进行初步评估。2023年2月，Getting It Right First Time (GIRFT) 国家项目发布了新的CES指南，其中包含了一个重要的实践变化：一个新的紧急转诊途径。

目的：

本研究旨在探索英格兰初级保健环境中对GIRFT指南的了解和使用情况。

设计与设置：

使用横断面在线调查来收集在英国各地工作的初级保健临床医生的数据。

方法：

通过目的抽样，该调查被分发给了英格兰的各个初级保健临床医生，并于2024年10月21日至2024年12月24日进行。RE-AIM框架支撑了调查设计。描述性分析用于解释频率和Likert数据。

结果：

共收到了来自英格兰所有42个综合护理委员会的515份回复。在515名参与者中，有452人（88%）了解CES指南或路径，其中297/515人（58%）知道GIRFT指南。三分之二的人能够访问当地的CES路径(n = 304/452, 67%)。几乎所有临床医生都强调，查阅当地CES路径或国家指南支持了他们的临床决策。

结论：

这是第一次研究调查英格兰初级保健中对GIRFT指南的了解和使用情况。研究表明，使用经过本地同意的CES路径可以增加遵守其建议的情况。这些发现表明，使用最新的当地CES路径可以使临床医生更好地遵循GIRFT指南。

关键词: CES；马尾综合征；临床实践指南；Getting It Right First Time (GIRFT)；知识转化；初级保健。

© 2025 The Author(s). Musculoskeletal Care published by John Wiley & Sons Ltd.