New departures in epilepsy care: an epilepsy liaison service.

Epilepsy care in the UK is patchy, fragmented and poorly coordinated. Primary care management is appropriate for many people with epilepsy but there are practical difficulties in delivering care at this level which renders the service that patients get far below the best they could receive. Epilepsy care in a primary setting is often not audited: patients managed purely in a primary setting may be denied access to recent advances in diagnostic techniques and therapies for epilepsy. As healthcare becomes more consumer led, purchasers of epilepsy care [largely general practitioners (GPs)] must be more aware of what they need to purchase to improve care for people with epilepsy within their own practice. People with epilepsy and their relatives are already beginning to make their own demands and requests for improvement in epilepsy care, both at primary and secondary levels of care: their needs will have to be taken into account. The Birmingham University Epilepsy Liaison Project aims to bridge the gap between primary and secondary care, and provide both advice about audit of epilepsy care and educational materials for the primary care physician. It also provides for better communication between the primary care physician, the patient and secondary and tertiary facilities. We hope, if it fulfils its designed function, that it will provide a model of future care for epilepsy in this country.