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

doi:10.1177/1055665617736779

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

National Institute for Health Research
University of Bristol
Addenbrooke’s Hospital
Gt. Ormond St. Hospital for Children

Research output: Contribution to journal › Article › peer-review

18 Citations (Scopus)

Abstract

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 language	English
Pages (from-to)	248-251
Number of pages	4
Journal	Cleft Palate-Craniofacial Journal
Volume	55
Issue number	2
Early online date	14 Dec 2017
DOIs	https://doi.org/10.1177/1055665617736779
Publication status	Published - 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).

Funding

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). The views expressed in this publication are those of the author(s) and not necessarily those of the National Health Scheme, the NIHR, or the Department of Health.

Keywords

Cleft care
Unilateral cleft lip and palate outcomes
United Kingdom

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10.1177/1055665617736779

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title = "Closing the loop on centralization of cleft care in the United Kingdom",

abstract = "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.",

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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). ",

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doi = "10.1177/1055665617736779",

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AU - Waylen, Andrea

AU - Smallridge, Jackie

AU - Hall, Amanda J.

AU - Sell, Debbie

AU - Sandy, Jonathan R.

N1 - 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).

PY - 2018/2

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N2 - 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.

AB - 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.

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

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