Closing the loop on centralization of cleft care in the United Kingdom

Andrew R. Ness, Andrew R. Wills, Andrea Waylen, Jackie Smallridge, Amanda J. Hall, Debbie Sell, Jonathan R. Sandy*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objective: We highlight a major study that investigated the impact of reconfigured cleft care in the United Kingdom some 15 years after centralization. We argue that centralization as an intervention has a major impact on outcomes. Setting: Audit clinics held in Cleft Centers in the United Kingdom. Patients, Participants: Five-year-olds born between April 1, 2005, and March 31, 2007, with nonsyndromic unilateral cleft lip and palate. Interventions: Centralization of cleft care. Main Outcome Measure(s): We collected routine clinical measures (speech recordings, hearing, photographs, models, oral health, psychosocial factors) in a very similar way to a previous survey. Results: We identified 359 eligible children and recruited 268 (74.7%) to the study. Overall, their outcomes were better postcentralization. There have been marked improvements in dentoalveolar arch relationships and in speech whereas the prevalence of dental caries and hearing loss are unchanged. Conclusions: Centralized cleft care has changed UK outcomes considerably and there is no argument for returning to a dispersed model of treatment.

Original languageEnglish
Pages (from-to)248-251
Number of pages4
JournalCleft Palate-Craniofacial Journal
Issue number2
Early online date14 Dec 2017
Publication statusPublished - Feb 2018

Bibliographical note

Funding Information:
This publication presents independent research commissioned by the UK National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RPPG-0707-10034).


  • Cleft care
  • Unilateral cleft lip and palate outcomes
  • United Kingdom


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