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Primary care is suited to managing epilepsy

We were dismayed to read the disparaging comments about GPs and practice nurses made in the article about reviewing patients with epilepsy (News, March 15).

What is the status of the relevant evidence of any benefit of specialist review of patients with long-term epilepsy, many of whom may have been diagnosed decades ago?

Surely the care of these patients, along with other equally complex and demanding chronic conditions, now belongs in primary care. Furthermore, there is evidence to show practice nurses manage such

chronic conditions very well and may

even offer some advantages in their approach and ability to adhere to evidence-based guidelines.

Many patients live with this lifelong condition and try to minimise its impact. Primary care is much more suited to helping them achieve this than secondary care. Brain scans and blood monitoring are available in primary care these days.

We feel much more confident than your article implies that the care of patients with epilepsy can be managed by GPs and practice nurses working together in primary care.

Dr Stephen Newell

Susan Neal, nurse practitioner,

Romford, Essex

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