Background: Repeat attendances to emergency departments for seizures, impacts on the individual and burdens health care systems. We conducted a review to identify implementable measures which improve the management of people with epilepsy reducing healthcare costs and their supportive evidence. Methods: A scoping review design using suitable search strategy as outlined by PRISMA-ScR was used to examine seven databases: MEDLINE, EMBASE, CINAHL, AMED, PsychINFO, HMIC and BNI. A manual search of the COCHRANE database and citation searching was also conducted. A thematic analysis was conducted to explore the context and reasons of emergency department attendance for seizures, particularly repeat attendances and the strategies and measures deployed to reduce repeat attendances. Results: Twenty-nine reports were included, comprising of a systematic review, a randomised control study, a multi-method study, quantitative studies (n = 17), qualitative studies (n = 6), an audit, a survey and a quality improvement project. Thematic analysis identified four broad areas for reducing repeat attendances. These were developing care pathways, conducting care and treatment reviews, providing educational interventions and role of ambulance staff. Conclusion: The findings indicate varied reasons for attendance at ED following seizure, including mental health and knowledge of seizure management and lack of education. Implementations of care pathways in ED have been found to reduce admission related costs.

Introduction: People with learning disabilities� in the United Kingdom are being incarcerated in hospital settings due to lack of suitable community care and support. �Factors influencing discharge from institutional/hospital care to enable successful community living have not been explored systematically. Method: A systematic review using the PRISMA guidance identified studies via five electronic database searches of Medline, CINAHL, Embase, psychINFO, and Cochrane Library. A predesigned inclusion/exclusion criterion was applied to selected articles. A thematic analysis approach was used. Results: Six qualitative and twelve quantitative articles were identified and divided into three broad themes of support, housing, and health. A further nineteen articles were identified as of peripheral interest. Conclusion:Factors affording a successful transition from hospital/institution to community are discussed. Suitable standards of housing, staff support/training, and health-care access influence the success of sustainable repatriation. An evidence-based tool kit is proposed from available factors to enable safe, sustainable, and timely discharge.

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