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8 March 2016

Study finds that 'innovative care pathways' could reduce seizure ambulance callout costs

A new study has shown that many patients with suspected seizures could potentially be treated more effectively and at lower cost by modifying the way ambulance calls are dealt with.

The study analysed data from phone calls to emergency services involving suspected seizure incidents in adults over the age of 16 between 1 April 2012 and 31 March 2013. 

Researchers looked at the Yorkshire Ambulance Service (YAS) region covering 6,000miles2 (9,656 km2) and serving a population of 4,954,876 people, including 4,019 610 adults. YAS has an annual budget of approximately £231 million and its boundary encompasses 20 contracted clinical commissioning groups.

Data from the study published in the British Medical Journal, showed that the majority of suspected seizures were rapidly self-limiting and only a minority of patients required immediate medical treatment.  In most cases, the seizure had ended and the patient was breathing normally by the time the ambulance arrived.

Researchers suggested that alternative strategies of managing emergency calls could include call handlers routinely staying on the line after making their decision to dispatch.  This would allow many incidents to be stepped down in priority once the seizure had stopped and the patient was breathing normally again.  

Only 8.3 per cent of the sample required emergency drugs for seizure termination.

There were no cases of cardiac arrest during the study. Despite this, most calls were given the highest priority, with a response time target of eight minutes.

The study concluded:

'Many patients with suspected seizures could potentially be treated more effectively and at lower cost by modifying ambulance call handling protocols. The development of innovative care pathways could give call handlers and paramedics alternatives to hospital transportation. Increased adoption of care plans could reduce 999 calls and could increase the rates of successful home or community treatment.

Epilepsy Society's Sapphire nurse consultant epilepsy commissioning , Juliet Ashton, said:

"This study provides hard evidence for what we have always known, that in many cases, better care pathways in the community for people with epilepsy could reduce the numbers of people needing to be transported to hospital following a seizure. The widespread adoption of  care plans could reduce the number of 999 calls and enable better home and community care.

"Epilepsy Society has worked with Epilepsy Action to develop an epilepsy commissioning toolkit to help commissioners design appropriate epilepsy services for people their community. This could make a huge difference to the lives of people with epilepsy and could bring about huge savings to the NHS."