Question to the Department of Health and Social Care:

To ask His Majesty's Government how many requests have been made to the Refractory Epilepsy Specialist Clinical Advisory Service since it was established; and how many NHS prescriptions have been made available to children and young people with drug resistant epilepsy as a result of its deliberations since it was established.

The Refractory Epilepsy Specialised Clinical Advisory Service (RESCAS) is a United Kingdom-wide panel of specialist clinicians who provide a clinical advisory service hosted by Great Ormond Street Hospital. The core membership of the RESCAS service is made up of consultant paediatric neurologists, specialist pharmacists, neuroradiologists, neurophysiologists, and genetics specialists.

The RESCAS service provides advice to other clinicians on complex cases of refractory, or drug-resistant, epilepsy. RESCAS supports decisions about treatment options, especially when cases are difficult or outside standard guidance, and provides advice on optimising epilepsy treatment, including the use of complex therapies including cannabinoids. It also provides advice about access to trials and emerging therapies.

The service supports clinical decision-making in situations where conventional treatment pathways have been exhausted, where evidence is limited or emerging, or where novel and non-standard therapies are under consideration. The RESCAS evidence base draws on multiple, complementary sources. These include national guidance and policy frameworks, such as National Institute for Health and Care Excellence guidelines and technology appraisals, NHS England commissioning policies, and relevant regulatory standards. In addition, the service incorporates professional consensus guidance, including specialist input from bodies such as the British Paediatric Neurology Association. This is further strengthened by scientific and clinical evidence, spanning published trials and research across anti-seizure medications, dietary therapies, surgical interventions, and novel or off-label treatments. Together, these components ensure that RESCAS advice reflects both current best practice and emerging developments in epilepsy care.

The Department and NHS England do not hold information on how many National Health Service prescriptions have been made available to children and young people with drug resistant epilepsy as a result of RESCAS advice.