Step Together

Step Together is guidance that has been developed by a multi-disciplinary group of professionals, in partnership with people with epilepsy and learning disabilities, their families, and their carers.

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About Step Together

The Step Together guidance describes what good quality integrated services for people with a learning disability and epilepsy should look like.

Our summary guide is aimed at encouraging commissioners and providers to audit existing services across both primary and secondary care to understand how they are meeting the needs of the population they serve and to better understand where there are gaps.

The guidance provides examples of how to increase collaboration, improve the provision of services, improve consistency of services, and reduce risk and unwarranted variation.

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Undertaking service evaluation enables commissioners to ask questions and encourage provider cooperation, quality improvement, and workforce development. Where gaps in provision or quality are identified, it shows how new or enhanced services could be commissioned.

We encourage pragmatic provider development solutions that can be facilitated as part of the ICS work streams, clinical audit programmes or quality improvement objectives. We suggest that local care pathways are documented, and protocols/practices agreed to deliver consistent and good care.

The guidance advocates reviewing the expertise and capacity of the workforce using competency frameworks to support skills and knowledge development and role extension.

See the full guideEasy read version

Step Together Benchmarking Tool kit – Service Evaluation

Epilepsy Action, in partnership with Professor Rohit Shankar, have developed this service evaluation tool kit, which has been successfully implemented on a regional level across the Midlands NHSE ICS systems as well as within other NHS Trusts across the country.

This tool kit is based on the Step Together Guidance, Purple Light Toolkit and the learning from the Clive Treacey Independent Review (Clive-Treacey-Independent-Review-Final-Report-9.12.21.pdf (

The approach adopted is a self-assessment questionnaire, which is integrated into a digital benchmarking tool kit. By completing the questionnaire, the whole service can be evaluated, helping systems to understand the qualities, standards and variation of epilepsy and learning disability services across an area, for example an integrated care system, an NHS Trust, or a devolved nation.

The Step Together implementation in the Midlands was a central part of Midlands and Lancashire CSU’s project “Creating capable communities – keeping people with learning disabilities and epilepsy safe and living well”, which has been shortlisted for a 2023 HSJ Patient Safety Award.

As part of Epilepsy Action’s call to action, we are committed to supporting other integrated care systems and service providers to use this tool kit to understand what their service looks like.

We will analyse the submitted digital response and provide a full report of the findings. Should you wish to undertake this service evaluation, it is important you register your interest via email at

Register your interest

Download the toolkit:

All applicants must return a copy of their Step Together toolkit results to Epilepsy Action by email upon completion. To get the most use of the toolkit, we recommend applicants arrange a call with our research manager before beginning completion.

The toolkit can be completed at the service, trust and ICS level. Your toolkit can give you the results for one individual service/trust/system. To compare between multiple services/trusts/systems, and to see how your results compare to the nationwide results, you must contact Epilepsy Action.

To download the Step Together benchmarking toolkit, please complete the following questions:

By downloading the toolkit, you agree to return a copy of your results to Epilepsy Action to contribute to our national monitoring of epilepsy services(Required)

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Organisations that have used the toolkit

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