ORCID

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 pronounced health inequalities affecting rural populations, ethnic minority groups, and people with intellectual disabilities. Diagnostic pathways remain inefficient, with prolonged waits for electroencephalography (EEG), low sensitivity of routine investigations, and repeated inconclusive testing. Long-term management continues to depend on infrequent hospital visits and unreliable patient recall, contributing to suboptimal seizure control, avoidable morbidity, and preventable mortality. In the United Kingdom, epilepsy affects over 630 000 people, accounts for approximately £2 billion in annual healthcare costs and exemplifies these systemic failures. Current hospital-centric care models are failing to meet their complex, often lifelong, needs. In its recent 2025 “Fit for the Future” 10-year plan, the UK government mandates three fundamental shifts in healthcare: from hospital to community, analogue to digital, and sickness to prevention. Epilepsy diagnosis and care exemplify the potential for this comprehensive triumvirate transformation, with emerging technologies including point-of-care EEG systems, AI-powered diagnostics, wearable devices, and digital therapeutics offering unprecedented opportunities to deliver specialist-level care in community settings and reduce illness burden. However, successful implementation requires addressing digital exclusion risks for vulnerable populations. We propose that technology-enabled community epilepsy care can serve as a blueprint for the UK's National Health Service (NHS) transformation while delivering immediate benefits for patients, families, and healthcare systems. The convergence of clinical need, technological capability, and policy imperative creates a unique opportunity to move beyond incremental improvements to fundamental system redesign that ensures equitable access to high-quality epilepsy care across all communities. Such a model, if delivered, could be an exemplar for other chronic conditions both in the United Kingdom and globally. Plain Language Summary: Current epilepsy care in the United Kingdom often involves long waits and relies on infrequent hospital visits, which is not ideal for a lifelong condition. New technologies, such as wearable devices and AI-powered tools, offer a chance to change this. By moving care from hospitals into the community, we can provide faster diagnosis, continuous monitoring, and more personalised support. This will help improve the lives of the 630 000 people with epilepsy in the UK, ensuring they receive better, more accessible, and more equitable care.

Publication Date

2026-04-11

Publication Title

Epilepsia Open

Acceptance Date

2026-03-06

Deposit Date

2026-04-11

Funding

There is no direct disclosure or conflict of interest for any author for this submitted body of work. JRT is a cofounder and managing director of Neuronostics Ltd and a Theme Lead for enabling technologies at the Epilepsy Research Institute. RS developed the noncommercial and free‐to‐use SUDEP and Seizure Safety Checklist and the EpSMon app to reduce the risk of SUDEP and enhance seizure safety. RS is the chief investigator of the NIHR‐adopted national Ep‐ID register. The Register is supported and monitored by the National Institute of Health Research, UK. The funding for each molecule examined by the Register is via an Investigator Initiated Support grant from each of the molecule's parent companies. The funding is provided to RS's NHS institution and goes toward the salary of the research coordinator and the institution's project oversight costs. The contributing companies till date include Eisai, UCB, Bial, Jazz Pharma (previously GW Pharma) and Angelini. This work sits outside the submitted work. In addition to the above, RS has received institutional research, travel support and/or honorarium for talks and expert advisory boards from LivaNova, UCB, Eisai, Neuraxpharm, Veriton Pharma, Bial, Angelini, UnEEG and Jazz/GW Pharma outside the submitted work. He holds or has held competitive grants from various national grant bodies, including Innovate, Economic and Social Research Council (ESRC), Engineering and Physical Sciences Research Council (ESPRC), National Institute of Health Research (NIHR), NHS Small Business Research Initiative (SBRI) and other funding bodies, including charities, all outside this work. No other author has any declared conflict of interest related to this paper. We confirm that we have read the journal's position on issues involved in ethical publication and affirm that this report is consistent with those guidelines. 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.

Keywords

capable community, equity, prevention, reform, seizures, technology

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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