Epilepsy is a common neurological condition affecting 1–2 percent of the population. At least 3,50,000 are affected in the UK, one quarter of whom have active epilepsy. There is higher representation of epilepsy in estimated 1.2 million learning disabled population in the UK. Rough estimates predict some 5 percent of such population are in institutional care; 30 percent requiring medical attention.

Lighthouse Healthcare provides inpatient tertiary care services to Learning Disability population with complex needs. A sizeable proportion of the inpatient population has complex and refractory epilepsy. As the services are provided at various hospital sites, we wanted to review the care of all the patients with epilepsy and compare it with national standards as set by the National Institute of Health and Clinical Excellence in England and Wales (NICE).

As most of the patients were already diagnosed elsewhere, we reviewed the medical records and compared the care with the standards envisaged in the NICE guidelines on the management of Epilepsies.

We contacted the Clinicians responsible for the care of all current inpatients and identified the cohort with epilepsy. We then reviewed the medical records for their conformity with NICE recommendations.

Besides missing records, we identified that there were major deficiencies in recording the breakthrough seizure activity as well as epilepsy review on yearly basis either by general practitioner or in specialist clinics.

The care provided to this vulnerable group falls short of standards expected in a secondary/tertiary care setting.