Impact of COVID-19 on paediatric epilepsy services and what learning points can be taken forward for the future

Objective: To investigate the impact COVID-19 has had on children's epilepsy services and what learning points can be taken forward for the future Methods: Emails were sent out to all members of the Eastern Paediatric Epilepsy Network (EPEN), a network of clinicians delivering paediatric epilepsy care in the east of England Members were asked to offer their perspective on how COVID-19 has affected the epilepsy service they provide, and what improvements could be taken forward for the future Qualitative data was collected from 25 respondents, representing all (100%) of the 16 units across the region Results: There was a shift from face-to-face patient consultations to telephone/video call On the whole this was very positively received by both families and staff Negatives brought up included issues surrounding safeguarding and difficult communication There was a big drop in numbers of patients arriving to ED A significant number of inappropriate attendances in ED were avoided, but there were examples of delayed presentations of children with severe disorders Several epilepsy specialist nursing teams struggled with the increased workload of dealing with families of complex patients who were not coping well with cancellation of schools/clubs/CAMHS etc Neurophysiology and imaging services were initially closed On re-opening, many patients 'shielding' were reluctant to come to hospital MDT meetings and teaching utilised videoconference platforms This was well received with greater turnouts than pre-COVID-19 Registrar training opportunities were reduced Looking into the future, responses foresaw a mixture of face-to-face and virtual consultations, and using virtual platforms for MDT meetings and teaching Conclusions: COVID-19 has had both positive and negative impact on children's epilepsy services In the future, undertaking clinical assessment, teaching, and multi-disciplinary work through use of remote technology will be the predominant benefits