Epilepsy patients sent to A&E

MANY EPILEPSY patients are being referred to hospital emergency departments for assessment and treatment by GPs to avoid the …

MANY EPILEPSY patients are being referred to hospital emergency departments for assessment and treatment by GPs to avoid the long waiting times they would otherwise have to endure before seeing a specialist, new research has found.

A survey of family doctors across the State found 91 per cent of them either always, sometimes or occasionally refer epilepsy patients to AE because of “protracted neurology waiting times”. Patients can wait 18 to 24 months to see a neurologist.

The survey findings, published in the Irish Medical Journal, state that only 9 per cent of GPs never refer patients to AE because of these waiting times.

Its authors state that international best practice guidelines recommend patients with suspected epilepsy be reviewed and diagnosed by a neurologist within two weeks.

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But in this study GPs “reported significant difficulties accessing neurology services for people with epilepsy”.

Only 5 per cent of GPs said they could always access an “urgent” neurology appointment within four weeks. Some 61 per cent of GPs said they could never do so, 19 per cent said they could occasionally access such appointments and 15 per cent said they could do so sometimes.

Furthermore only 6 per cent of GPs said they could always access an urgent MRI scan within 12 weeks. Some 36 per cent said they could never do so.

The GPs who were surveyed admitted though that patients with private health insurance do access neurology services more quickly. Over 70 per cent of GPs believed this to be the case.

As well as epilepsy patients finding it difficult to access specialists, they face an additional difficulty in that one third of family doctors reported a knowledge deficit when it came to managing patients with the condition. “Acknowledging their own knowledge deficits, GPs in this study face significant barriers in managing people with epilepsy in the primary care setting,” the authors state.

Because of the long waiting times to see a neurologist many patients “may be referred inappropriately to the emergency department and the final cost of this is unknown”.

Furthermore it states the deficits highlighted “may be contributing to sub-optimal care”.

There are up to 37,000 people over the age of five with epilepsy in Ireland. It is the most common serious neurological condition after stroke requiring long term, multidisciplinary care.

Brainwave, the Irish Epilepsy Association, recently criticised the fact that epilepsy has suffered historical neglect and lack of investment. Its chief executive Mike Glynn said there were just 20 neurologists in the State when at least 42 were required to meet minimum European standards.