Secondary care costs to the NHS for children born with unilateral cleft lip and palate, bilateral cleft lip and palate and cleft palate from birth to 10 years of age

  • Saleem A Hasanally

Student thesis: Doctoral ThesisDoctor of Dental Surgery (DDS)


The aim of this study was to undertake a micro-costing approach to determine the
secondary care costs to the National Health Service (NHS) associated with the cleft care
pathway of patients being treated from birth until 10 years of age for bilateral cleft lip and
palate (BCLP), cleft palate only (CPO) and unilateral cleft lip and palate (UCLP). This was
compared to NHS reference and tariff costs.
A care pathway was mapped out for a child born with BCLP, CPO and UCLP. 23 case notes of
children born with orofacial clefting were identified. Retrospective data collection of
episodes of care were recorded. Costs of care were calculated using local and national
sources in order to compare against NHS reference and tariff costs.
Mean costs for BCLP, CPO and UCLP were £17,004.09 (SD £7,361.83), costs £6,137.49 (SD
£2,319.87) and £11,619.74 (SD £2,547.81) respectively. Costs in BCLP were the highest due
to the increased surgical care required when compared with CPO and UCLP. CPO had the
lowest mean cost due to the least surgical care required. Did not attend (DNA) rates were
similar in each of the phenotypes ranging from 5% and 8% of total appointments missed.
Costs for provision of care for BCLP, CPO and UCLP from birth to 10 years of age are
significant and can vary based on the surgical and outpatient care provided. Staff costs
formed the largest proportion of costs identified
Date of Award26 Nov 2020
Original languageEnglish
Awarding Institution
  • The University of Bristol
SupervisorTony Ireland (Supervisor), Jonathan Sandy (Supervisor) & Joanna C Thorn (Supervisor)

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