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These pathways are the new care pathways for children born with cleft lip and palate in Scotland. We are reducing the number of appointments all cleft children have to attend. These changes are evidence based and minimise the impact of care on you and your child, especially on your child’s education. To help reduce the need to travel, you will also be offered the opportunity to have a virtual appointment for some clinics rather than coming to clinic yourselves but the choice will be yours. Again, this is to reduce the impact on you, especially if you have to travel a long way.
These changes will not affect the quality of care your child receives.
The Cleft Care Scotland network brings together professionals (surgeons, doctors, nurses, speech and language therapists, psychologists, orthodontists ,dentists and audiologists) involved in care of people with cleft lip/ and or palate, third sector organisations and patients and their families to look at improvements in cleft care services in Scotland. An important part of this is agreeing a care pathway for all cleft patients in Scotland, based on current evidence, and looking at it regularly to make sure the pathway still delivers the right level of care.
The pathway may change a little during the time of your care as we learn more about what is important and when, including what is important to you. The care pathway sets out all the things that need to be done at certain times so that we can make sure, where possible, everything is covered at one visit and you are only asked to come to appointments when necessary.
The changes in the pathway have been reviewed and agreed by all members of the cleft network
There are a number of network clinicians who will be involved in you/ your child’s cleft care. Sometimes you will see them together as a cleft team and sometimes you will see them separately. The cleft care pathway sets out what is needed and when. Your child needs to be seen at certain times on the pathway by the cleft team. The team is made up of cleft surgeons, cleft nurses and psychologists. The team will only need to see you at other times if you have a concern or an appointment has been requested by a local clinician. You may have been told in the past to expect a review with the cleft team at other times but these will be changed.
After your child’s initial cleft surgery and review at the age of one, the next time your child will see the whole cleft team together will be at age five. Between the ages of one and five, they will see a local dentist every 6 months. If your child has a cleft palate, they will have a cleft speech therapy review every 6 months after surgery and a hearing check at least once a year by audiology and a member of the Ear Nose and Throat (ENT) team.
After the age of five, the next time your child will be seen by the cleft team is at age ten. If the gum (alveolus) is involved they will have a clinic appointment at the age of seven to see the cleft team and assess the need for a bone graft to be carried out. If a bone graft is needed, your child will be seen 6 months after surgery to check its success. Between the ages of five and ten your child should continue to be seen by your local dentist every six months.
After the age of ten, the next time your child will see the cleft team will be at the age of fifteen and for a lot of patients, that will be the last time they need to be seen. In this period your child will continue to see your local dentist and a local orthodontist if needed. Some patients will continue to be seen after they reach the age of fifteen.
We know families may be expecting routine clinic appointments that differ to those outlined above. If you are not sure, please contact the Surgical Service administration team based in Glasgow on 0141 451 6524 / e-mail ggc.cleftteamscotland@nhs.scot and they can advise you.
By clicking on the CLAPA logo below you will access a general idea of what to expect in the patient pathway for cleft care. Please note that services do differ within the UK so please refer to Cleft Care Scotland’s Cleft Lip, Cleft Lip & Palate and Cleft Palate pathways, contact your local health care team or the Cleft Surgery Service in Glasgow on 0141 451 6731 / e-mail ggc.cleftteamscotland@nhs.scot if you have any queries about your care.
