Intended for healthcare professionals


Avoiding premature death in epilepsy

BMJ 2015; 350 doi: (Published 10 February 2015) Cite this as: BMJ 2015;350:h718

Re: Avoiding premature death in epilepsy

The Association of British Neurologists endorses Professor Risdale’s call (1) for general practitioners to be remunerated for epilepsy monitoring—just as they are for other important long-term conditions such as like diabetes—and would welcome more general practice input to epilepsy care.

People with any long-term condition need help to take responsibility for their self-management and to become more equal partners in their care. Epilepsy is common (prevalence 0.75%) and serious; even those who are seizure free require regular review to discuss their ongoing treatment options. With such large numbers of people affected it is not practical for epilepsy management to be focused solely in secondary care.

Until 2014, epilepsy comprised part of the UK primary care Quality Outcomes Framework (QOF). This helped primary care engagement with the clinical management of epilepsy, improved epilepsy care in the community, gave people with epilepsy better access to specialist input, and may have helped to limit the tragedy of epilepsy-related death (2). Removal of epilepsy from the QOF is a shortsighted and backward step and we call, on behalf of our patients, for this to be reinstated.

Phil Smith
on behalf of the Association of British Neurologists


1. Ridsdale L. Avoiding premature death in epilepsy. BMJ 2015;350:h718 doi: 10.1136/bmj.h718.

2. Shankar R, Cox D, Jalihal V, Brown S, Hanna J, McLean B. Sudden unexpected death in epilepsy (SUDEP): development of a safety checklist. Seizure 2013;22:812-7.

Competing interests: No competing interests

27 February 2015
Phil E Smith
Consultant Neurologist
President Elect, Association of British Neurologists
Professor Phil E Smith, Department of Neurology, The Epilepsy Unit, University Hospital of Wales, CArdiff, CF14 4XW