Epilepsy and Lone Working: Guidance for Employers and Employees

The number of people working alone — whether from home, on the road, or in isolated settings — has increased significantly in recent years. For most employees, lone working is simply a feature of modern working life. For individuals with epilepsy, it raises specific questions that employers and employees need to consider carefully.

This article sets out the key issues around epilepsy and lone working, with practical guidance for both employers managing their duty of care and individuals navigating their own working arrangements.

What Is Lone Working?

Lone working describes any situation in which an employee works without direct supervision or close proximity to other colleagues. This includes:

• Working from home (WFH), including hybrid arrangements
• Field-based or mobile work (e.g., visiting clients, surveying, delivery)
• Opening or closing a premises alone
• Working in a separate area or building from colleagues
• Overnight or out-of-hours work

For the purposes of epilepsy risk, what matters is not simply whether someone is physically alone, but whether they would receive timely help if a seizure occurred.

Why Lone Working Requires Specific Consideration

In a shared workplace, a colleague is typically nearby if a seizure occurs. Help can be called, the environment can be made safe, and the individual can be monitored during recovery.

In a lone working scenario, none of this is guaranteed. A person may:

• Be unaware they have had a seizure if they experience postictal confusion
• Be unable to call for help during or immediately after a seizure
• Remain unresponsive without anyone being aware
• Be injured in an environment that has not been risk-assessed for seizure safety

This does not mean that people with epilepsy cannot work alone. Many do, safely and effectively, with appropriate planning in place. The purpose of a risk assessment is to identify what measures are needed — not to create barriers to employment.

The Employer’s Duty of Care

Employers have a legal duty to manage the health and safety of lone workers under the Health and Safety at Work Act 1974 and the Management of Health and Safety at Work Regulations 1999. Where an employee has disclosed epilepsy, this duty extends to considering the specific risks that lone working may present for that individual.

This does not mean employers must prohibit lone working for anyone with epilepsy. It means they must:

• Carry out an individual risk assessment
• Consider what measures would adequately manage any identified risks
• Implement those measures as reasonable adjustments where appropriate
• Review arrangements regularly, particularly if seizure control changes

Blanket exclusions from lone working — applied without individual assessment — may constitute discrimination under the Equality Act 2010.

Carrying Out an Individual Risk Assessment

An effective lone working risk assessment for an employee with epilepsy should consider the following:

Seizure Frequency and Control

The starting point is understanding the individual’s current seizure picture. Key questions include:

• How frequently do seizures occur?
• Are there any known triggers (e.g., fatigue, stress, missed medication)?
• Does the individual have warning signs (an aura) before a seizure?
• What do their seizures look like — are they convulsive, or do they involve altered awareness?
• How long does recovery typically take?

This information should come from the employee, and where relevant, from occupational health with the employee’s consent.

The Working Environment

Consider the specific environment in which lone working takes place:

• Are there physical hazards that could cause injury during a seizure (e.g., stairs, hot surfaces, water, sharp edges)?
• Is the employee working near machinery or at height?
• How long might they be uncontactable before anyone would notice?
• Is there a reliable mobile or internet connection?

A home environment, for example, presents different risks from a field-based role or a client’s premises.

The Nature of the Work

Some tasks carry a higher inherent risk if a seizure occurs during them. These include:

• Driving (which is governed separately by DVLA regulations)
• Working with or near water
• Operating machinery
• Working at height
• Customer-facing or public-facing roles where a seizure could create secondary risk

These do not automatically preclude the individual from lone working, but they require specific consideration.

Practical Measures for Managing Risk

Once risks have been identified, a range of practical measures may be appropriate depending on individual circumstances.

Check-In Systems

A regular check-in protocol is one of the most straightforward and effective measures. This involves the employee contacting a designated colleague, manager, or monitoring service at agreed intervals. If contact is not made, a pre-agreed response is triggered.

For working from home arrangements, this might involve:

• A scheduled morning and afternoon check-in call or message
• Use of a workplace messaging platform with an agreed response expectation
• An automated check-in app or device

The interval between check-ins should reflect the nature of the individual’s seizures and recovery. If a seizure typically involves 30 minutes of postictal confusion, a check-in every two hours provides a different level of protection than one every four hours.

Seizure Alert Technology

A range of wearable devices and apps are available that can detect movement patterns consistent with a convulsive seizure and trigger an alert to a designated contact. These vary in accuracy and function, and their limitations should be understood — they do not replace human supervision, and not all seizure types will be detected.

Where an employee chooses to use such technology, it can form part of a broader safety arrangement. Employers should not, however, rely solely on technology as a substitute for adequate risk management.

Environmental Adjustments at Home

For employees working from home, a basic environmental review can reduce the risk of injury during a seizure. This might include:

• Using a desk chair with arms rather than a stool
• Ensuring the working area is free of hard edges or objects that could cause injury if the person falls
• Avoiding working in rooms with hard flooring where possible, or using a rug in the working area
• Keeping a mobile phone within reach at all times
• Considering whether working on a ground floor reduces the risk associated with stairs

Employers may wish to include a home working safety checklist as part of their lone working arrangements.

Flexible Working Adjustments

For some individuals, specific adjustments to working patterns can reduce seizure risk during lone working hours. These might include:

• Avoiding early morning starts if seizures are more likely in the morning
• Building in regular breaks to prevent fatigue
• Avoiding shift patterns that disrupt sleep
• Ensuring medication can be taken at consistent times within the working day

These adjustments should be agreed in consultation with the employee.

Buddy Systems

Where the nature of the work allows, a buddy system can provide an additional layer of safety. This involves pairing a lone worker with a designated colleague who has a shared awareness of their situation and takes responsibility for initiating a check-in or response if contact is not made.

Working From Home: Specific Considerations

The growth of remote and hybrid working has brought a particular set of challenges for employees with epilepsy that many organisations have not yet fully addressed.

The Absence of Immediate Colleagues

In a home environment, there is no colleague in the next room. If a seizure occurs, the individual may be alone for an extended period before anyone is aware. This is a meaningful distinction from working in a shared office, and risk assessments should reflect it.

Family Members and Co-Residents

Where an employee lives with others — a partner, family member, or housemate — it may be appropriate to consider whether those individuals are aware of what to do in the event of a seizure. This is a personal matter and cannot be required by an employer, but it can be raised sensitively as part of a broader safety conversation.

Where someone lives alone, the absence of any co-resident increases the importance of a robust check-in system.

Video Calls and Visibility

Regular video calls provide a degree of informal visibility. If an employee does not appear for a scheduled video meeting and cannot be reached, this can serve as a prompt for a welfare check. This should not be relied upon as a primary safety measure, but it is worth noting as part of the broader picture.

Connectivity and Emergency Response

Home workers should ensure that emergency services can be summoned reliably from their working location. This includes:

• Knowing their home address precisely (important during an emergency call)
• Having a mobile phone charged and within reach
• Being aware of whether smart speakers or other home devices can be used to make emergency calls

The Employee’s Perspective

For individuals with epilepsy, lone working can feel like a difficult balance. There may be a desire for independence and the flexibility that home working offers, alongside an awareness of the risks involved.

Employees are not obliged to request adjustments — but it is in their interest to engage with the risk assessment process honestly. Withholding relevant information from an employer does not transfer risk away from the individual; it leaves them without the support that a proper assessment might identify.

Some practical steps employees can take independently include:

• Keeping a mobile phone accessible at all times during working hours
• Informing a trusted person — whether at work or at home — of their working hours and whereabouts
• Knowing and following any DVLA guidance relevant to their situation
• Reviewing their home working environment for obvious hazards
• Discussing any changes in seizure frequency or medication with their employer or occupational health provider promptly

When Lone Working May Not Be Appropriate

In a small number of cases, the risks associated with lone working may not be adequately manageable, even with reasonable adjustments in place. This might apply where:

• Seizures are frequent, uncontrolled, or unpredictable
• The role involves high-risk activities (such as working at height or with dangerous machinery) that cannot be modified
• A seizure could create serious risk of harm to the individual or others, and no adequate supervision or monitoring arrangement is achievable

In these circumstances, the employer and employee should explore whether alternative duties or arrangements are available. Lone working should not be excluded without a thorough individual assessment, and any decision to restrict working arrangements should be documented carefully, with the legal framework in mind.

Summary: Key Principles

Epilepsy and lone working can be managed safely with the right approach. The key principles are:

• Individual assessment, not blanket policy
• Practical measures proportionate to identified risk
• Honest, collaborative engagement between employer and employee
• Regular review, particularly when circumstances change
• Clear emergency protocols, even in a home environment

The goal is not to restrict opportunities for people with epilepsy — it is to ensure that when they work alone, they do so as safely as possible.

National Epilepsy Training provides specialist training for employers, HR teams, and health and safety professionals. If you would like support in conducting lone working risk assessments or developing workplace epilepsy policies, please get in touch.