The UK Department of Health has published guidelines to be used by doctors with a special interest in epilepsy, working towards the government's aim, published in the NHS Plan, of having up to 1,000 GPs (local doctors) with special interests in a range of conditions and treatments by 2004.
GPs with Special Interests (GPwSI) will be either employed by Primary Care Trusts or Acute Trusts usually for a number of sessions each week. The services provided by GPwSI will not be equivalent in breadth to those of a consultant in the same service area and they will normally continue to practice as local doctors while undertaking this new role. Their role will be to support GPs in the area to improve their epilepsy service.
In the guidelines, doctors with a special interest in epilepsy are encouraged to:
- provide a clinical service for patients with epilepsy, including where appropriate, care to special groups (e.g. those with learning disabilities, pregnant women, and adolescents)
- support practices to use templates for annual review of patients with epilepsy and to assist them in carrying out audits of their care of patients with epilepsy and to develop an epilepsy register.
- have up-to-date information of how to access education, employment and related social aspects of epilepsy.
- have the ability to undertake a full medical and neurological history with access to the appropriate investigations to make an accurate diagnosis of epilepsy.
- understand the psychosocial aspects of epilepsy.
- have a sound knowledge of the pharmacological treatments for epilepsy, their uses, side effects, drug interactions, and effect on the foetus and the implications of drug treatment in preconception care and the management of breast-feeding mothers, and
- understand the role of the voluntary sector and other support organisations.
The Department of Health claims the GPwSI scheme has been a success for other conditions. As part of modernisation of ENT (ear, nose and throat) services in Oxfordshire, local doctors refer patients direct to a fellow doctor with over twenty years ENT experience. Patients wait on average just 24 days for a consultation and 61 per cent of referrals can be discharged without reference to a hospital ENT department. 97 per cent of patients felt confident in seeing a doctor with a special interest in the place of a consultant.
New guidelines have also been published for GPs with special interests in child protection, drug misuse, emergency care, headaches, mental health, palliative care, respiratory disease, sexual health and dermatology.
A spokesman for the charity Epilepsy Action welcomed the guidelines:
"These are positive developments for people with epilepsy. Last year's National Sentinel Audit of Epilepsy Related Deaths showed that 54 per cent of adults with epilepsy and 77 per cent of children with epilepsy were receiving inadequate care and there we would encourage Primary Care Trusts to appoint specialists in epilepsy to help improve services for people with the condition in the UK."