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Publication - Dr Andrew Wills

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


    Ness, AR, Wills, AK, Waylen, A, Smallridge, J, Hall, AJ, Sell, D & Sandy, JR, 2018, ‘Closing the Loop on Centralization of Cleft Care in the United Kingdom’. Cleft Palate-Craniofacial Journal, vol 55., pp. 248-251


    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.

    Full details in the University publications repository