Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what guidance exists on which clinician - GP or neurologist - is responsible for reviewing and managing medication for patients with Functional Neurological Disorder and non-epileptic seizures.

Integrated care boards (ICBs) are responsible for commissioning services that meet the needs of their local populations and for ensuring that providers deliver services in line with national service specifications. NHS England oversees this process and has mechanisms in place to assure compliance with these standards.

Where services are not meeting required standards, NHS England oversees system performance through established accountability arrangements, including routine oversight and engagement with ICBs across a range of domains such as access, quality and outcomes. Where concerns about service provision or variation are identified, NHS England works with ICBs and providers to support improvement, including through planning guidance, performance discussions, and system oversight processes.

NHS trusts are accountable to their boards, and to their local systems, for the quality and safety of the services they provide and are expected to act where gaps in provision or access are identified.

The Government recognises that access to appropriate psychological therapies and multidisciplinary support for people with functional neurological disorder (FND), including non‑epileptic seizures, can vary between areas. The majority of services for people with neurological conditions, including FND, are commissioned locally by ICBs.

The National Institute for Health and Care Excellence provides guidance to support clinicians in recognising and managing FND, and promotes a coordinated, multidisciplinary approach to care, including access to psychological therapies where clinically appropriate.

NHS England’s specialised neurology service specification requires all specialised neurology centres to ensure access to appropriate treatment services for FND, delivered through integrated pathways involving neurological, mental health and community services.

There is no single nationally mandated clinician responsible for reviewing and managing medication for patients with FND and non-epileptic seizures. Decisions about prescribing and reviewing medicines are made by the clinician responsible for that aspect of the patient’s care, which may be a general practitioner, neurologist or other specialist, depending on the patient’s needs and where care is being delivered.

In practice, medication management is typically undertaken through shared care arrangements, with clinicians working together to ensure patients receive safe, appropriate and person‑centred treatment based on clinical judgement.