Closing the Loop on Centralization of Cleft Care in the United Kingdom

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

Research output: Contribution to journalArticle (Academic Journal)peer-review

5 Citations (Scopus)
424 Downloads (Pure)


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 post-centralization. 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


  • cleft care
  • unilateral cleft lip and palate outcomes
  • United Kingdom

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