NHS services for epilepsy from the patient's perspective: a survey of primary, secondary and tertiary care access throughout the UK

N Moran, K Poole, G Bell, J Solomon, S. Kendall, M McCarthy, D McCormick, L Nashef, A Johnson, J Sander, S Shorvon

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)


The aims of this study were to estimate the proportion of patients with epilepsy who made primary care and/or hospital outpatient medical consultations within 1 year; to formulate a model of the explanatory variables that influence whether patients consult or not; and to estimate the frequency of referral to, and waiting time for, hospital outpatient clinics in patients with new-onset seizures. Suggestions are offered for improvement of epilepsy services based on the findings. A questionnaire was distributed to 3455 unselected patients identified at population level from primary care practices in all NHS regions of the UK. There were 1652 respondents with epilepsy of all types, irrespective of aetiology, duration or severity. Fifty-two per cent of the whole sample made at least one medical consultation of any type specifically for epilepsy (42.0% primary care, 30.5% hospital, 20.4% both). Most patients with controlled epilepsy (74.5%) had no consultations. Of patients with severe epilepsy, 27.5% made no primary care consultations, 43.4% no hospital consultations and 14.1% no consultations of either type. Gender did not influence the likelihood of either GP or hospital consultations in patients with either controlled or active epilepsy. Increasing seizure frequency was associated with a greater likelihood of one or more hospital consultations for epilepsy, whereas increasing duration of epilepsy was associated with a decreased likelihood of either type of consultation. Age affected consultation rates: of those patients over the age of 65 years, only 29.9% made a medical consultation for epilepsy, compared to 53.8% of young adults. Patients under the age of 17 years were less likely to have consulted a GP and more likely to have consulted a hospital doctor. Ninety percent of new-onset patients had been referred to a hospital doctor, and the mean wait was 6.5 weeks. In conclusion, many patients with epilepsy, including severe epilepsy, are not receiving specialist input, and a significant proportion are receiving no medical supervision. The elderly are over-represented in this group. Care tends to be polarized between hospital or primary care, falling short of the ideal of shared care. It will be important to address the influences on consultation seeking in epilepsy, particularly for those patients currently under no medical supervision.
Original languageEnglish
Pages (from-to)559-65
Number of pages7
Issue number8
Publication statusPublished - 2000


  • Adolescent
  • Adult
  • Aged
  • Child
  • Epilepsy
  • Female
  • Great Britain
  • Health Services Accessibility
  • Health Services Needs and Demand
  • Health Services Research
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Patient Care Team
  • Patient Satisfaction
  • Primary Health Care
  • Referral and Consultation
  • State Medicine


Dive into the research topics of 'NHS services for epilepsy from the patient's perspective: a survey of primary, secondary and tertiary care access throughout the UK'. Together they form a unique fingerprint.

Cite this