Guide to managing Epilepsy at work

Employer’s guide to managing epilepsy at work

Epilepsy is one of the most common neurological conditions in the world. There are over 600,000 people in the UK with a known diagnosis of epilepsy. Every week over 600 people are given the diagnosis.

Epilepsy can affect anyone of any age, gender, race or ethnicity. Characterised by seizures caused by excessive electrical activity in the brain, it can be debilitating and dangerous for people and employers.

If you haven’t already, it’s likely that you will interview or employ someone with epilepsy at some point in your career. As the prevalence of the condition is increasing, so is the likelihood that it will grow as a workplace risk too.

What is epilepsy?

Epilepsy is a condition that affects the brain. When someone has epilepsy, it means they have a tendency to have epileptic seizures.

There are over 40 different types of seizure known as epilepsy. The seizures are different in type and severity for each individual. Seizures usually last a short time and the brain works normally between them. Some people find their seizures are triggered by certain things, such as not getting enough sleep or skipping meals.

Some people with epilepsy may only experience seizures while they are awake and fully aware. This might mean the seizure takes the form of an unusual taste or smell. Some people with epilepsy may have seizures where they jerk, fall down and lose consciousness. Others may only have seizures when they are asleep.

Whilst there are many drugs and therapies available, 30% of people live with uncontrolled seizures that do not respond to medication. The impact on families and carers can be significant, especially if they face the challenge of managing round-the-clock care.

Recruiting someone with epilepsy

Most people with epilepsy will have the same skills and abilities as those who don’t have the condition. The Equality Act 2010 means the condition is not likely to be a barrier to employment, unless there are safety critical elements to a role.

Prospective candidates for jobs are not obliged to tell an employer they have epilepsy before a job offer is made. It would usually automatically be illegal to retract a job offer after it is made, just because someone has epilepsy.

Most employers ask new employees to complete a medical questionnaire after a job offer is made, to ascertain whether any reasonable adjustments may be required. This is usually completed confidentially via occupational health. Many people with epilepsy do not require any adjustments or support in the workplace.

Newly diagnosed epilepsy

You may find an employee receives an epilepsy diagnosis when they’re already employed in your business. Although they’re not obliged to tell you if they don’t want to, most people are open and transparent about the condition.

It is often identified because employees may have bouts of sickness absence, or sometimes because an employee has a seizure at work.

It is common for people to take different amounts of time to adjust to a new way of life if they do receive a diagnosis. Sensitivity and support are essential if it happens. CBT can be very helpful (if it is available) and Employee Assistance Programmes are very useful support channels too.

Impact on work

It can be very difficult to predict how epilepsy may affect performance at work. This is because there are so many different types of seizure and they differ in severity between individuals and over time too – they often get better or worse.

Sometimes seizures may happen at work and individual performance may also be affected by anti-epilepsy medication. Accessing professional advice via occupational health or an individual’s GP is essential for an employer to show they are supporting employees appropriately.

If treatment is optimised, which can take time to achieve, most people with epilepsy can remain seizure free.

Reasonable adjustments at work

The Equality Act 2010 means employers must consider making reasonable adjustments to support people with a disability in the workplace. Adjustments relating to epilepsy are usually very specific to the individual, because the range, severity and frequency of seizures can vary so much.

Adjustments to a role or environment suggested by occupational health practitioners may include:

• allowing a person to adjust their working hours, perhaps to start or finish work later
• setting regular shift patterns that do not vary, if shift work triggers seizures
• avoiding unplanned overtime if fatigue may trigger a seizure
• allowing time away from work to attend medical appointments
• re-allocating elements of a role to another team member if they can no longer be done because of epilepsy e.g. climbing up ladders
• providing access to a quiet place where an employee could rest after a seizure
• consider providing a support driver where the person cannot drive and public transport is not practical

Adjustments may not need to be permanent.  Support may only be needed temporarily, perhaps until medication begins to control symptoms or if someone is undergoing a medication change.

Epilepsy and medication

Many people with epilepsy are treated successfully with a drug or with a combination of medications. There is often wide variation in the effectiveness of drugs between different people and the side effects that may be caused.

It can sometimes take many weeks for a treatment regime to stabilise. Many people with epilepsy find they can tolerate medication without intrusive side-effects. However, people do often report problems when medication (the type or the dose) is being changed.

Funding any adjustments

Discounting recommended adjustments solely on the grounds of cost is not without risk for employers. Employers must be able to demonstrate they have considered the actual costs and practicability of any adjustments.

Financial support may be available from the Access to Work scheme, which can help cover the costs of a proposed adjustment, fund taxi journeys and pay for equipment that may help.

Employers are not required to create a new role someone if that role did does not already exist in the business.

Talking with employees

If an employee discloses they have epilepsy to a manager or human resources then the employer is deemed to know of the person’s condition. That triggers the responsibility to consider reasonable adjustments and to address any health and safety risks.

Sometimes employees may disclose the condition but ask that colleagues are not informed. This can be tricky if, for example, working patterns may need to be changed without a supervisor or team member being told.

Where this happens, occupational health specialists would usually advise informing colleagues of the need for an adjustment to be made, but without disclosing any medical diagnosis.

Display screen equipment

Most people with epilepsy do not struggle to use computers, however, a small proportion (around 4%) of people with epilepsy are photosensitive. This means that visual stimulus such as flickering lights and computer games can trigger seizures.

LCD screens do not flicker, so can remove the trigger for photosensitive epilepsy. However, they do not protect from flashing or flickering content being displayed e.g. flashbulbs at a press conference on TV.

Working with hazards

It’s rational to be concerned about working in environments where seizures could have serious consequences for workers, colleagues or customers.

The DVLA has issued guidelines for people who drive which are based upon individual risk assessment. The same principles are often applied to those working with machinery too.

Anyone who works at heights, drives, operates motorised equipment or machinery, works with fires, metals, furnaces, deep water or with prolonged periods alone will need individual risk assessment and support (usually via occupational health).

First aid at work

The number of first aiders you have and the equipment they may have available usually depends upon the level of hazard associated with the job and the size of the workforce.

The HSE recommends providing extra training for first aiders if you have employees with disabilities. Epilepsy Action has very useful information about what to do if someone has a seizure at work, as well as free online first aid course.

Epilepsy Action also has a free employers toolkit and a free seizure action plan template, which many employers find helpful when supporting employees with epilepsy.