Paediatric surgery

The Department of Health in England has agreed to a proposal that will see it take responsibility for epilepsy surgery in children and young people. 

Epilepsy Action believes that this is a major success and big step forward.  This will increase the number of operations carried out each year. It should see a number ‘centres of excellence’ for epilepsy surgery being set up across England.

Earlier in the year Epilepsy Action members campaigned by writing to the National Specialised Commissioning Team, supporting the proposal. Thank you for this. You helped show that there is demand from patients, families and carers for better surgical options for epilepsy.

Paediatric epilepsy surgery in Scotland is already nationally commissioned to a specialist centre, at the Royal Hospital for Sick Children in Edinburgh. All neurosurgery in Wales is also commissioned nationally. The few people in Northern Ireland who are approved for surgery are referred for investigation to other areas of the UK.  

Sometimes surgery can be seen as a ‘last resort’ when all other treatments have not worked. But delaying or not offering surgery when a child may benefit could impact on their development. And the safety and success of surgery has increased significantly over the last twenty years. 

According to current statistics there are around 48,000 under-18s in England with epilepsy. Around 100 paediatric neurosurgery operations are carried out each year to treat epilepsy. While surgery is not an option for the majority of children, figures suggest that less than a quarter of the operations needed are currently carried out.

At the moment, fifteen centres in England offer some children’s neurosurgery. Around fifty neurosurgeons operate on children, and only a very small number carry out children’s neurosurgery full-time. The proposal will mean there will be fewer centres, but these will be better equipped and staffed than the current service.

The new ‘national’ service will be paid for by taking a small amount of money from all health trusts. This means hospitals will have already paid for a share of surgery, and may be encouraged to refer more children who might benefit.

The process of deciding where the new national centres will be based has already started. It is expected that the sites will be decided by the end of the year.