2021 Election Campaign – More Epilepsy Specialist Nurses

For the sixth Scottish Parliament election, we decided to make six asks of the next Scottish Government and group of MSPs elected.

Our Policy Assistant, Anna Telfer, provides information on our second election ask, which is to ensure there is at least one adult and one paediatric Epilepsy Specialist Nurse in each health board.

Epilepsy Specialist Nurses (ESNs) are a vital line of support for people with epilepsy.

They promote a greater understanding of the condition and empower individuals, and their carers, to manage their epilepsy through advice and support.


The benefits of ESNs

There is a consensus amongst researchers about the importance of ESNs.

There is evidence that epilepsy specialist nurses reduce the strain on acute services; one study found A&E attendances from children with epilepsy halved after a paediatric ESN was employed.

Other studies argue that ESNs assist in reducing seizure frequency through medication management and intervening when there are non-compliance issues.

There is a broad consensus in the literature that epilepsy specialist nurses support work to reduce the mental health burden currently experienced by people with epilepsy.

One study assessed the economic impact of employing an ESN, they found that one ESN managed to avoid nearly £85,000 in costs over the course of a year.

Through intervention and support the ESN managed to save expensive costs like avoidable A&E attendances and unnecessary calls to consultants.


The need in Scotland

The Scottish Intercollegiate Guideline Network (SIGN) develops evidence based clinical practice guidelines for the NHS in Scotland. These are viewed as the gold standard model of care.

The SIGN epilepsy guidelines recommend that each epilepsy team should include ESNs. The Royal College of Nursing recommend there should be at least one epilepsy specialist nurse per 250 patients.

Due to the lack of knowledge about Scotland’s epilepsy population – how many, if there are any geographical concentrations, burden of need – it is difficult to evidence exactly where areas need improvement.

However, it is clear there are areas which need significant improvement.

In Tayside, two nurses are managing an active adult caseload of 1,500 patients and there is currently no adult ESN in the Borders.

The postcode lottery of access to good epilepsy support must come to an end.


Epilepsy Scotland’s 2021 number two election ask

We know ESNs offer vital support to people with epilepsy. We would like the next administration to recognise this by ensuring there is at least one adult and one paediatric ESN in each health board.

This will improve equity of access to care and ensure people with epilepsy in more rural health boards have access to this support to better manage their condition.

To safeguard quality and timely access to this vital support, we also ask that no ESN is managing an active caseload of over 300 patients.

This means more populated health boards should expand their ESN service provision to protect the safety of patients and ensure no ESN is overworked.

Increasing access to ESN support in Scotland will better support people with epilepsy to manage their condition better and hopefully minimise the impact epilepsy has on their life.

You can read our full manifesto here which includes information on how you can get involved.