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

PLoS One. 2023 Sep 14;18(9):e0290882. doi: 10.1371/journal.pone.0290882. eCollection 2023.

Abstract

Background: Cauda Equina Syndrome is a serious spinal pathology, which can have life changing physical and psychological consequences and is highly litigious. Litigation can have negative personal and professional effects on the healthcare professionals cited in a clinical negligence claim. There is an absence of research looking at the experience of the physiotherapist and as such, it is unknown the impact litigation is having on them. This study explored the lived experiences of UK physiotherapists in relation to Cauda Equina Syndrome litigation.

Methods: A qualitative design, informed by Gadamerian hermeneutic phenomenology, using semi-structured interviews was used to explore participants' lived experiences of litigation. Interviews were audio-recorded and transcribed verbatim. Findings were analysed using an inductive thematic analysis framework. Nvivo software was used to facilitate analysis. The study is reported in accordance with the consolidated criteria for reporting qualitative (COREQ) research.

Results: 40 interviews took place online or over the phone, with physiotherapists and stakeholders. Four themes were found; 'litigation effects', 'it feels personal', 'learning from litigation' and 'support and training'.

Conclusion: This is the first study to investigate the lived experiences of litigation in UK physiotherapists. Involvement in clinical negligence affected physiotherapists' physical and mental wellbeing and impacted their clinical practice. Most physiotherapists felt litigation was a personal attack on them and their ability to do their job. Physiotherapists highlighted perceptions of a 'blame culture' and perceived stigma associated with the claim, which often led to a lack of sharing and learning from litigation. Physiotherapists emphasised the need for emotional support for those going through a legal claim and that training was needed to understand the process of litigation and range of potential outcomes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cauda Equina Syndrome*
  • Humans
  • Malpractice*
  • Physical Therapists*
  • Qualitative Research
  • United Kingdom

Grants and funding

GY, SG, JS, EW received a grant to support this research from the Chartered Society of Physiotherapy Charitable Trust (Grant number PRF/19/A18). https://www.csp.org.uk/about-csp/how-we-work/charitable-trust The funder played no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.