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Abstract

Epilepsy is recognized to be a significant cause of premature mortality, socio-economic distress and poor quality of life in economically developed countries.Despite clear clinical guidelines, epilepsy care is marked by delayed diagnosis,fragmented management, high emergency admission rates, and pronouncedhealth inequalities affecting rural populations, ethnic minority groups, and peo-ple with intellectual disabilities. Diagnostic pathways remain inefficient, withprolonged waits for electroencephalography (EEG), low sensitivity of routineinvestigations, and repeated inconclusive testing. Long-term management con-tinues to depend on infrequent hospital visits and unreliable patient recall, con-tributing to suboptimal seizure control, avoidable morbidity, and preventablemortality. In the United Kingdom, epilepsy affects over 630 000 people, accountsfor approximately £2 billion in annual healthcare costs and exemplifies thesesystemic failures. Current hospital-centric care models are failing to meet theircomplex, often lifelong, needs. In its recent 2025 “Fit for the Future” 10-yearplan, the UK government mandates three fundamental shifts in healthcare: fromhospital to community, analogue to digital, and sickness to prevention. Epilepsydiagnosis and care exemplify the potential for this comprehensive triumviratetransformation, with emerging technologies including point-of-care EEG sys-tems, AI- powered diagnostics, wearable devices, and digital therapeutics offer-ing unprecedented opportunities to deliver specialist-level care in communitysettings and reduce illness burden. However, successful implementation re-quires addressing digital exclusion risks for vulnerable populations. We proposethat technology-enabled community epilepsy care can serve as a blueprint forthe UK's National Health Service (NHS) transformation while delivering imme-diate benefits for patients, families, and healthcare systems. The convergence ofclinical need, technological capability, and policy imperative creates a uniqueopportunity to move beyond incremental improvements to fundamental systemredesign that ensures equitable access to high-quality epilepsy care across allcommunities. Such a model, if delivered, could be an exemplar for other chronicconditions both in the United Kingdom and globally.

Publication Date

2026-04-11

Publication Title

Epilepsia Open

Acceptance Date

2026-03-06

Deposit Date

2026-04-11

Funding

JRT acknowledges the financial support of EPSRC via grant EP/T027703/2. Both authors acknowledge the financial support of EPSRC via grant EP/W035030/1.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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