A telemedicine-enabled nurse-led epilepsy service is acceptable and sustainable

Epilepsy nurse specialists and neurologists each have important roles in managing epilepsy patients. We have devised a model where the nurse specialist travels to the patient's local hospital but the neurologist does not. The nurse specialist sees the patient first and telephones the neurologist if there are problems requiring his expertise. If the situation cannot be resolved, then the neurologist establishes a videolink with the nurse and patient. The proof of any new system is whether it stands the test of time so we report our experience over the last five years. In a survey of patient satisfaction, 113 of 155 (73%) questionnaires were returned in 2001 and 72 of 100 in 2003 (72%). Ninety percent of responders agreed that 'I'd be happy to be seen this way again' in the first survey and 100% in the second. Since 2002, a total of 1804 patients have been seen. The number of patients seen each year has remained relatively constant at approximately the maximum capacity for the system. Two-thirds of patients are now dealt with by the nurse alone. We did not analyse our costs fully, but there were obvious savings in the neurologist's time.