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<p>The Public Health England (PHE) report Deaths associated with neurological conditions
in England 2001 to 2014, was developed by PHE’s Neurology Intelligence Network (NIN),
and published on 27 February 2018. The report found that a greater proportion of epilepsy
related deaths occur in areas of higher levels of deprivation. A copy of the report
can be found at the following link:</p><p> </p><p><a href="http://www.gov.uk/government/publications/deaths-associated-with-neurological-conditions"
target="_blank">www.gov.uk/government/publications/deaths-associated-with-neurological-conditions</a></p><p>
</p><p>Wider research has shown that epilepsy prevalence varies with social deprivation,
but this is not well understood, and it is not clear whether this inequality in mortality
is the consequence of the increased prevalence seen in deprived areas, of poor care,
or both. However, deprivation is a well-known determinant of poor general health,
and although there is insufficient evidence to describe the relationship as causal,
it underlines the health inequalities link in relation to epilepsy related deaths.</p><p>
</p><p>The Government is acting broadly to reduce health inequalities by addressing
the social causes of ill health, promoting healthier lifestyles for all and tackling
differences in outcomes of NHS services, all underpinned by legal duties. Through
the Mandate the Government has asked NHS England to ensure service commissioning focuses
on measurable reductions in inequalities in access to health services, in people’s
experience of the health system, and across a specified range of health outcomes which
contribute to reducing inequalities in life expectancy and healthy life expectancy.
National and local outcomes frameworks feature indicators to measure improvements
across a range of areas, including inequalities, and the Mandate asks NHS England
to do more in increasing the transparency on services and outcomes that these frameworks
provide.</p><p>At a national level, NHS England is the organisation responsible for
securing and supporting high quality outcomes for people with epilepsy, and the vast
majority of services for people with the condition are planned and commissioned by
local clinical commissioning groups. Action is led locally to ensure the solutions
put in place reflect the needs of individual communities.</p><p> </p><p>NHS England’s
Rightcare programme provides practical support to local commissioners to tackle unwarranted
variation, including in services for neurological conditions like epilepsy.</p><p>
</p><p>NHS England is also working with the Neurological Alliance to support a new
Neurology Advisory Group, led by Professor Adrian Williams, to align work across the
system to improve neurological care. In addition to developing the neurology mortality
report, PHE’s NIN provides a broad range of data on disease, services and outcomes,
including for epilepsy, to support local commissioners to benchmark services and drive
improvement. The new neurology mortality report will provide further focus for commissioners
in considering whether there are any changes they need to make in terms of service
planning and provision, including around the inequality issues identified.</p><p>
</p><p>Ministers routinely meet the system leaders to discuss a broad range of issues
concerning population health, including long term health problems. The Department
works closely with NHS England and PHE to support delivery of the Mandate and systems
objectives. The Department and NHS England are also represented on PHE’s NIN. NHS
England officials hope to meet with the charity SUDEP (Sudden unexpected death from
epilepsy) Action shortly to discuss the findings of the PHE report.</p><p> </p><p>We
are investing over £1 billion a year in health research through the National Institute
for Health Research (NIHR), and the NIHR has advised that it is not currently funding
any research into premature epilepsy mortality. The usual practice of the NIHR is
not to ring-fence funds for expenditure on particular topics: research proposals in
all areas compete for the funding available. The NIHR welcomes funding applications
for research into any aspect of human health, including epilepsy. These applications
are subject to peer review and judged in open competition, with awards being made
on the basis of the importance of the topic to patients and health and care services,
value for money and scientific quality.</p>
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