The future of epilepsy care in the United Kingdom: A roadmap for technology-enabled transformation.

Epilepsy is recognized to be a significant cause of premature mortality, socio-economic distress and poor quality of life in economically developed countries. Despite clear clinical guidelines, epilepsy care is marked by delayed diagnosis, fragmented management, high emergency admission rates, and pronounced health inequalities affecting rural populations, ethnic minority groups, and people with intellectual disabilities. Diagnostic pathways remain inefficient, with prolonged waits for electroencephalography (EEG), low sensitivity of routine investigations, and repeated inconclusive testing. Long-term management continues to depend on infrequent hospital visits and unreliable patient recall, contributing to suboptimal seizure control, avoidable morbidity, and preventable mortality. In the United Kingdom, epilepsy affects over 630 000 people, accounts for approximately £2 billion in annual healthcare costs and exemplifies these systemic failures. Current hospital-centric care models are failing to meet their complex, often lifelong, needs. In its recent 2025 "Fit for the Future" 10-year plan, the UK government mandates three fundamental shifts in healthcare: from hospital to community, analogue to digital, and sickness to prevention. Epilepsy diagnosis and care exemplify the potential for this comprehensive triumvirate transformation, with emerging technologies including point-of-care EEG systems, AI-powered diagnostics, wearable devices, and digital therapeutics offering unprecedented opportunities to deliver specialist-level care in community settings and reduce illness burden. However, successful implementation requires addressing digital exclusion risks for vulnerable populations. We propose that technology-enabled community epilepsy care can serve as a blueprint for the UK's National Health Service (NHS) transformation while delivering immediate benefits for patients, families, and healthcare systems. The convergence of clinical need, technological capability, and policy imperative creates a unique opportunity to move beyond incremental improvements to fundamental system redesign that ensures equitable access to high-quality epilepsy care across all communities. Such a model, if delivered, could be an exemplar for other chronic conditions both in the United Kingdom and globally. PLAIN LANGUAGE SUMMARY: Current epilepsy care in the United Kingdom often involves long waits and relies on infrequent hospital visits, which is not ideal for a lifelong condition. New technologies, such as wearable devices and AI-powered tools, offer a chance to change this. By moving care from hospitals into the community, we can provide faster diagnosis, continuous monitoring, and more personalised support. This will help improve the lives of the 630 000 people with epilepsy in the UK, ensuring they receive better, more accessible, and more equitable care.