What is the Welsh Government doing to a) increase the number of epilepsy specialist nurses and b) ensure every health board has dedicated epilepsy experts?
The Welsh Government want to ensure that all people living with chronic neurological conditions, including Epilepsy, have access to safe and high-quality services. This is at the heart of the Quality Statement for Neurological Conditions (the Quality Statement) published by Welsh Government in November 2022.
The Quality Statement Quality Statement for Neurological Conditions sets out our ambition and strategic direction for health services for people with neurological conditions, and the outcomes and standards we expect health boards to achieve in delivering those services. Whilst there is no specific target for epilepsy referrals in Wales, all Quality Statements reference the delivery of treatment in line with the extant evidence, and relevant clinical guidance and standards, including those published by the National Institute for Health and Care Excellence. We expect all NHS organisations in Wales to use the Quality Statement as the basis for planning how services for people with neurological conditions are developed and delivered.
All health boards are supported nationally to implement the Quality Statement through the National Strategic Clinical Network for Neurological Conditions (NSCNNC) in NHS Wales Performance and Improvement. The NSCNNC has being leading a number of areas of work regarding epilepsy, these include:
- The development of an Epilepsy Summary Dashboard: With data provided by the health boards, this is managed by Digital Health and Care Wales (DHCW and shared with health Board to enable benchmarking and peer review, identify areas of good practice, and highlight regional variation.
- Scoping the Epilepsy Clinical Nurse Specialist (CNS) workforce across Wales: This is being done in line with National guidelines such as NICE, (National Institute for Health and Care Excellence) and SIGN (Scottish Intercollegiate Guidelines Network) which recommend all patients with epilepsy have access to an Epilepsy Specialist Nurse.
- The development of a National Optimal Pathway for Epilepsy in Pregnancy: This will improve the quality and safety of care for women and reducing the risk of Sudden Unexpected Death in Pregnancy (SUDEP).
- The development of a Non-Specialised Paediatric Epilepsy Service Specification: This is being done in collaboration with the Child Health Network and NHS Wales Joint Commissioning Committee (NHSWJCC). It will outline service standards and the expected workforce who will be required to support babies, children and young people following a suspected seizure, and support timely diagnosis, access to treatment, care, and mental health support. It will also outline expectations for the appropriate transition of care between paediatric and adult services.
The NHS Wales workforce is supported through national education and training arrangements led by Health Education and Improvement Wales (HEIW). HEIW commissions pre-registration nursing education to sustain workforce supply and funds post-registration training, including advanced practice and independent prescribing, which underpin the development of specialist capabilities such as epilepsy care. While HEIW provides national leadership on education and workforce development, responsibility for workforce deployment and service configuration rests with health boards and trusts, who assess local population needs and ensure appropriate access to epilepsy expertise within their services. These considerations will also inform the development of the Welsh Governments new national workforce strategy for the NHS, to be published in the autumn.