Epilepsy: policy context
Relevant policies
Currently there is no national strategy specifically for epilepsy. However, epilepsy care is addressed within broader frameworks and policies for neurological conditions. The Neurological Care and Support: Framework for Action 2020-2025 is one such initiative. This framework aims to improve care and support for all neurological conditions, including epilepsy. Additionally, there is an active cross party group on epilepsy in the Scottish Parliament, which works to address issues related to epilepsy care and support.
In August 2007 Audit Scotland published a report on Managing Long-Term Conditions. This made recommendations about improving the care of people with long-term illnesses. The study focused on two conditions in particular, Chronic Obstructive Pulmonary Disease (COPD) and epilepsy. The main report, a summary of key messages and a podcast are available from Audit Scotland. The Scottish Government 2007 strategy document Better Health, Better Care includes many references to long term conditions. In 2008 the Health and Social Care Alliance published "Gaun Yersel", a self-management strategy for people with long-term conditions in Scotland.
Guidelines and standards for practice in Scotland
Guidelines for clinical practice in Scotland are currently provided by the Scottish Intercollegiate Guidelines Network (SIGN), part of Healthcare Improvement Scotland (HIS). Guidance for the diagnosis and management of epilepsy was published in May 2015 in SIGN 143 and updated in 2018.
Epilepsy Scotland published "Epilepsy in Later life: a Good Practice Guide" in 2008, which was recently updated and published as "Epilepsy and later life".
NHS Healthcare Improvement Scotland (HIS) published Clinical Standards for Health Neurological Services in October 2009, which included a section on epilepsy. They were created to address the variability of services available to those with neurological conditions. In May 2016, the Scottish Government supported Healthcare Improvement Scotland’s commitment to review the 2009 standards. Following this in March 2019, HIS published General standards for neurological care and support to ensure consistency in approach to neurological care and support services. The standards set out the same high level of care and support for all adults in Scotland regardless of their neurological condition, care setting, geographical location or personal circumstance.
In England a National Service Framework for Long Term Conditions was published in 2005. The National Institute for Health and Clinical Excellence (NICE) published a clinical guideline in April 2022 which covers diagnosing and managing epilepsy in children, young people and adults in primary and secondary care [NG217].
Epilepsy12 was established in 2009 and is a UK-wide audit of paediatric epilepsy services led by the Royal College of Paediatrics and Child Health. It has the aim of helping epilepsy services, and those who commission health services, to measure and improve the quality of care for children and young people with seizures and epilepsies. National reports were published in 2012 and 2014 and included Health Boards and Trusts across England, Northern Ireland, Scotland and Wales.
The Royal College of Paediatrics and Child Health published the State of Child Health 2020 report which includes a section on epilepsy. It reports that emergency admissions for epilepsy are associated with a deprivation gradient, and in Scotland, children living in the most deprived areas are nearly twice as likely to be admitted to hospital with epilepsy compared to their least deprived peers.
