00.00, Monday 23 June 2014
41 Portland Place The Academy of Medical Sciences
London
Fellows are invited to attend a discussion dinner at the Academy, featuring a talk by Professor Jonathan Sandy FMedSci, Professor of Orthodontics, University of Bristol.
Attendance costs £60 per head. Fellows may bring one non-Fellow guest.
For more information, contact info@acmedsci.ac.uk or book a place using the form below.
Centralisation of service can build research
Across the globe, a child is born with an oro-facial cleft every three minutes. This is a common congenital anomaly but each specific phenotype is rare. These children and their families require cleft care from birth until adulthood from a range of healthcare professionals.
Twenty years ago the cleft service in the United Kingdom was dispersed and organised into 57 centres such that the average cleft surgeon was operating on about five of these children every year. A Clinical Standards Advisory Group study (1998) showed poor outcomes and recommended that 10-15 centres should be designated for cleft care and treatment. The belief was that centralisation would increase volume and raise proficiency and efficiency as well as improving outcomes. A long and painful process achieved this centralisation, albeit some 15 years after the recommendations were made.
A significant NIHR programme grant has enabled examination of the same process and outcomes that informed centralisation. It appears that the intervention of centralisation has improved outcomes by about 50%. In parallel, this has created an opportunity for research to improve our understanding of the aetiology of the anomaly and best care through randomised controlled trials and observational studies. This is potentially a model for other low incidence anomalies which are easily neglected in the United Kingdom health care system.