There have been very few national audits of the care provided to patients with epilepsy. The confidential enquiry into maternal deaths in epilepsy and the Clinical Standards Advisory Group report identified deficiencies in the care of people with epilepsy in the UK. However, the Department of Health's response was lukewarm and additional investment earmarked for services was not forthcoming. Neither epilepsy nor neurological conditions moved up the list of priorities for commissioning. Similarly, the National Services Framework for longer term conditions did not come with ring-fenced resources. So, will the National Audit of Seizure Management in Hospitals (NASH)1 receive a similar response? This is possible, but we should take encouragement from the success of other national audits, such as those for stroke or chronic obstructive pulmonary disease, since they played a major role in driving up standards and moving these conditions up the commissioning agenda.

Seizures account for 2–3% of emergency …