I am the lead for the SUDEP and Seizure Safety Checklist (https://sudep.org/checklist) (2010 to present) to assess record and communicate SUDEP risk. The tool is used by epilepsy clinicians across UK and internationally (https://www.epilepsy.org.au/sudep-checklist/). It is converted to a self-empowerment mobile application – EpSMon (www.epsmon.com). Both tools have been evaluated across health & research communities. They have won the ILAE UK expert led poster 2015, patient safety awards 2016, Health Business Awards 2016, British Medical Journal awards 2016 (Neurology), 2017 * (Innovation) 2019 (Education) and US SUDEP Challenge award 2016 winner(83 applicants/25 countries). It is 1/7 projects selected by NHS England for the National Innovation accelerator programme 2017. A Cochrane review (2016 -CD011792) on SUDEP prevention singles out EpSMon. The RCGP has recommended EpSMon to all 70,000 GP practices through e-module training (2016)for epilepsy management & the BMJ commissioned a CPD module. Both Checklist & EpSMon are part of national epilepsy commissioning (http://www.epilepsytoolkit.org.uk/) and NHS RightCare toolkits. A recent NIHR review of emerging epilepsy technology has given the highest rating for EpSMon (page61). Key recent publications of 15 – https://doi.org/10.1016/j.yebeh.2019.07.020
https://doi.org/10.1016/j.yebeh.2019.106514 https://doi.org/10.1111/ene.13651 https://doi.org/10.1080/14737175.2018.1439738I initiated, implemented and co-ordinate a monthly mental health phone in with BBC radio Cornwall (2010). It has run continuously for 9 years, delivered 105 episodes. The significant impact on local community is evidenced -
https://doi.org/10.1192/bjo.2019.51
Overprescribing/polypharmacy has been recognised to be a significant UK wide problem in people with DD (https://www.england.nhs.uk/learning-disabilities/improving-health/stomp/). An evidence based systemic approach led by me to de-prescribing is being adopted nationally and internationally. Evidence of successes and challenges – https://doi.org/10.1111/jar.12635
https://doi.org/10.1111/bld.12272 https://doi.org/10.1136/dtb.2018.000009 https://doi.org/10.1371/journal.pone.0204178 https://doi.org/10.1111/bld.12206
Do not flush your life away a public health campaign to reduce male suicides - https://www.cornwall.gov.uk/health-and-social- care/public-health-cornwall/public-health-campaigns/dont-flush-your-life-away/
I have been the lead for various national projects aimed at a holistic approach for people with DD and epilepsy. This includes identifying and mitigating the national problems, challenges in work force, resources and competency of various stakeholders involved in the care of these complex individuals. These National reports are –
https://www.rcpsych.ac.uk/improving-care/campaigning-for-better-mental-health-policy/college-reports/2017-college- reports/management-of-epilepsy-in-adults-with-intellectual-disability-cr203-may-2017 https://www.rcpsych.ac.uk/improving-care/campaigning-for-better-mental-health-policy/college-reports/2017-college- reports/prescribing-anti-epileptic-drugs-for-people-with-epilepsy-and-intellectual-disability-cr206-oct-2017 https://ilaebritish.org.uk/content/uploads/2019/06/ESNA-Midazolam-Guidelines.pdf
NHS RightCare national commissioning toolkit & NHS England national epilepsy pathway
Do not flush your life away - https://www.cornwall.gov.uk/health-and-social-care/public-health-cornwall/public-health- campaigns/dont-flush-your-life-away/ finalist for the BMJ Awards 2017.
The Purple Book - Book a tool for self-empowerment and monitoring on psychotropic and anticonvulsant medication for people with ID
I have developed a standardized 30 minute e-learning test to enable trainers across the UK to test their course attendees’ understanding of delivering good care and rescue Midazolam medication. The e-test includes videos to examine the candidate’s ability to identify the practical procedures required in Buccal Midazolam administration with the aim of ensuring the trainee has gained the necessary learning during training. The e- test was created in partnership and consultation with local, regional and national level epilepsy experts, service users, carers and charities. The website was tested for quality standards and is supported as a source to improve patient safety by our stakeholders including the JEC, the International League of Epilepsy UK chapter, SUDEP Action, Epilepsy Action, South West Epilepsy Nurses group, Peninsula Academic Health Science Network and two NHS Trusts. It was formally launched on the 17th September 2013 at the South –West Epilepsy Conference and was shortlisted for the HSJ awards 2014 and national patient safety awards 2015. This has now been adopted by Cornwall Council and reaches all Cornish registered organizations (16000 carers). This model is being looked to being adopted in other parts of the country. I am leading a collaborative of ILAE UK and ESNA to redevelop the National rescue epilepsy guidance.
I have developed a checklist to support safe transfer of patients with ID across regions to address and mitigate some of the concerns raised in the Winterbourne enquiry. This checklist has been approved by the RCPsych executive and is approved as good practice by the National LD senate.
I am a co-developer of the intervention ‘SMART CART’ which has been awarded the internationally acclaimed Medical Futures innovation award (14/06/07).
I helped conceptualize, arrange and organize the mock OSCE now CASC exam (13 continuous stations) for the Part 3 MRCPsych clinical entrants. The mock exam is bi annual and is well received. It caters to all examinees in the South-West region of UK. Places for candidates outside Cornwall are sold at nominal rates and funds generated through this help buffer the Trust CPD budget. This was awarded the Royal College of Psychiatrists (south west division) Innovation award for 2009.
I was successful in acquiring 2 separate £5000 grants from the Peninsula Deanery to help develop training DVDs. The projects have been completed successfully. The first project on CASC DVDs is a well-recognized part of the clinical exam preparation now with sales being nationally and internationally. The money from the sale of DVDs goes towards the Trust continued professional development funds for the Trust doctors. This was awarded the Royal College of Psychiatrists (south west division) Innovation award for 2011 and was ‘highly commended’ at the BMA book awards.
Our new quality of life and communication e- tool ‘Cornwall epilepsy radar’ is being piloted.
A New pathway for consent to assist GPs and easy read for female patients who have learning disability to foster informed choice and communication around oral contraceptive use and antiepileptic medication.
I helped conceptualized mental health podcasts for GPs in Innovait (The RCGP training journal) which is now a regular monthly feature.