• Limited clinic capacity with unpredictable demand
• Small team – unable to cover absence to prevent clinic cancellation
• Low frequency of clinics causing delay if appointment not suitable for the patient
• Clinic booked by Epilepsy Unit admin staff – if admin staff on leave the clinic slots are not filled
• Consultant triage’s fax referrals – delay if unavailable
• Patient anxiety and concern re implications of a diagnosis e.g. driving
• Stigma attached to Epilepsy
• Patients put off by unit name – diagnosis seems pre-determined
• Nurses unable to refer for EEG leading to delay in diagnostics and confirmed diagnosis
• Primary Care does not have fast track access for first seizure clinics
• Primary Care are not made aware if a patient DNA’s so can’t follow up

Emergency Unit, Radiology, Neurophysiology, Medical Records, A&C staff, Consultants, Specialist Nurses, Ambulance Trust, Cardiology, Psychology, Care of the Elderly, Neurosurgery, Prison, Voluntary Sector, Practice Nurses, GP’s, Family members/ witnesses, Drug & Alcohol Services, Occupational Health, Referral Management Centre, Obstetrics, Management, Communications Department, Patients

• Develop a nurse led emergency unit assessment service for patients experiencing a first seizure
• Change the name of the “Epilepsy Unit” to the “Alan Richens Unit”
• Develop nurse led first seizure clinics to cover when Consultants unavailable
• Develop dedicated fast track clinic for Primary Care referrals
• Enable specialist nurse referral for EEG