Metastatic spinal cord compression (MSCC) occurs when metastatic disease causes vertebral collapse or compression of the spinal cord or when a tumour extends into the epidural space. It is an oncological emergency which will cause paralysis if left untreated. It is crucial that acute hospital staff recognise ‘red flag’ signs and symptoms of MSCC and adhere to the National Institute for Health and Care Excellence (NICE) guideline on MSCC recognition and management.

In 2019, a serious untoward incident involving a patient with confirmed MSCC was reported at an acute trust in England. This prompted the acute oncology team to examine the management of patients with MSCC at the hospital. A poster and mnemonic highlighting the main NICE recommendations were developed and distributed to all acute wards and areas. This article describes how that resource was developed and how the acute oncology team assessed its effects by conducting a two-phase retrospective and prospective audit.