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Cleft Surgical Services Proposal for NHS Scotland

These web pages provide details of the consultation on the proposal to improve the national specialist Cleft Surgical Services for NHS Scotland.

It also explains how you can feedback your comments on this proposal.

The Proposal

The proposed change to a single surgical service on one site at the Royal Children’s Hospital (RCH) and the Queen Elizabeth University Hospital (QEUH) in Glasgow aims to provide a safe, resilient and sustainable cleft surgical service which provides a quality service for all patients with a cleft of the lip and/or palate wherever they live in NHS Scotland. The changes are not about saving money as the current budget for the service in NHS Scotland for cleft surgical service will remain the same. Providing specialist surgery for Cleft Lip and Palate on a single site will ensure that these resources are used more effectively and efficiently.

The proposed change means that the Cleft Surgical Service would be configured as a single site. A central surgical base which will provide the specialist cleft surgical procedures but will continue to support the majority of cleft clinical care locally within existing out-patient and other existing local services.

All specialist cleft surgery would be transferred to Glasgow and most care will still be provided locally at outpatient services across Scotland and through visits to paediatric dentists, orthodontists, speech therapy as well as psychosocial support.

Currently the surgical service is being provided by three surgeons (two in Glasgow and one in Edinburgh). They manage approximately 90 children born with a cleft lip and or palate each year in Scotland, with a roughly even division of referrals between the two sites.

Main Benefits of the Proposal

The benefits of this proposal are that:

  • A single surgical team will be formed of three surgeons to provide a sustainable specialist surgical care for all patients with a cleft lip and/or palate;
  • The surgeons will work to support each other, learn from each other and develop as a team to build on existing strengths to continually improve on outcomes for all patients;
  • Communication between the surgical team will be improved by being physically co-located within the same base for part of the week;
  • The service will be able to manage the workload more efficiently and ensure that periods of pressure are better managed and planned for to ensure all patients receive their surgery when clinically required.

Impact of the Proposal

The change will mean that some patients will have to travel further for their surgery. For patients resident in Highland, Grampian and Tayside the need to travel for cleft surgery is already well established and the difference in the travel time for patients from these areas is relatively small.

Patients and families from Fife, the Edinburgh area, East Lothian and the Borders will have marginally longer travelling times. Patients from West Lothian will have, at most, a marginal change in journey times.

According to figures provided by the Cleft Care Scotland Network (Clinical Audit System), there is approximately an average of 90 new patients per annum for all of Scotland. On average NHS Lothian, NHS Fife and NHS Borders account for about 20 of these. The two centres do a combined total of approximately 250 inpatient/day-case procedures each year approximately 140 of those performed in the Glasgow hospitals and approximately 110 in Edinburgh. Of the 110 in Edinburgh only 53 or so patients living in Lothian, Borders and Fife would have to travel further for surgery than at present.

There is sufficient parent accommodation for one parent to stay with a child whilst in Glasgow for their planned specialist procedure and any patient or families that are currently able to claim travel expenses reimbursement will continue to be able to do so.

Tell us what you think

We are now consulting with the patients, parents and interested parties on this proposal. Comments are welcome and if you wish to comment on our proposal then please do so by 1st May 2016. You can do this in a number of ways as an individual, group or organisation by:

  • Calling us: 0131 275 6269
  • E-mailing us: [email protected]
  • Writing to us:

    Cleft Surgical Services Proposal,
    National Services Division,
    NHS National Services Scotland,
    Gyle Square,
    1 South Gyle Crescent,
    Edinburgh EH12 9EB

We are arranging a number of public meetings across Scotland which will be held in the evening with suggested dates:

  • Perth – 10th March 2016
  • Edinburgh – 16th March 2016
  • Glasgow – 17th March 2016

We are also holding a telephone conference consultation event on the afternoon of 10th March.

If you would like to attend one of these events then please get in touch with us using the details above and advising which event you would like to attend. We are committed to ensuring that everyone who wishes to comment can do so.

You can access more detailed information available on the proposal by going online at:

The outcome of the consultation will be reported to the National Specialist Services Committee in June 2016, who will make a recommendation on the proposal to be considered by the NHS Board Chief Executives and the Cabinet Secretary for Health and Well-being.

If you require this leaflet or the more detailed document in an accessible format, such as large print or Braille, or in a different language, please telephone 0131 275 6269.

Last Updated: 19 November 2018