The COVID-19 pandemic has enforced a number of changes in how we care for people who have had first seizures as well as those who have epilepsy. Some of these changes have been necessary due to the initial reallocation and redistribution of neurology clinicians to support colleagues caring acutely for patients presenting to hospital with COVID-19 related complications. After this rapid, mass shift in the allocation of health service personnel to cope with the first wave of the pandemic, changes to how clinicians can serve their patients in an epilepsy service remained essential to continue to minimise the risk of transmission of the virus by adhering to Government guidelines. For example, this made the delivery of routine face to face clinical care unviable for the short term. Instead a number of innovations were required which focused mostly on the utilisation of remote clinical methods of working.
The term ‘telemedicine’ is often heard and relates to the remote utilisation of both old and new technology, to enable high standards of clinical care to continue to be delivered. This has meant that clinics for epilepsy and first seizures have been conducted remotely, utilising telephone or secure video conferencing technology. Ensuring confidentiality of patient information is of the utmost importance for the NHS and as such commercially available software such as Zoom or Skype were not fit for this purpose. This turbocharged the development of NHS designed software platforms that have highlighted the level of innovation and flexibility of our healthcare system in times of adversity.
Clinicians from the epilepsy team at the Walton Centre and the epilepsy research group at the University of Liverpool have been involved in both advising on the safe implementation of these changes locally, regionally and nationally. They have already published their opinions on the topic and plans are in place for a national study on how best we can ensure that these changes in how care is delivered remains patient centred and fit for purpose. Although it is clear that telemedicine in epilepsy care is likely to be here to stay, we must ensure that it remains accessible to all of our patients to ensure that nobody is left behind. People with seizures, epilepsy and their carers should know that although the way we deliver care may appear seemingly different than before, their clinicians are always there for them when they need us. This may even give us an opportunity to rebuild our care pathways so that they are even more patient focussed, individualised and truly fit for the 21st century.