Centralisation of services for children with cleft lip or palate in England: a study of hospital episode statistics 

In 1998, a process of centralisation was initiated for services for children born with a cleft lip or palate in the UK. Using Hospital Episode Statistics (HES) data, we studies the timing of this process in England according to its impact on the number of hospitals and surgeons involved in primary surgical cleft repairs. A total of 8,606 children with a non-syndromic cleft lip and/or palate, born between April 1997 and December 2008, were identified. The number of hospitals carrying out primary cleft repairs on non-syndromic children reduced from 49 in 1997 to 13, with 11 of these performing repairs on at least 40 children born in 2008. The number of surgeons responsible for repairs reduced from 98 to 26, with 22 each performing repairs on at least 20 children born in 2008. Average length of hospital stay reduced during the same time period. We found that the speed of centralisation varied across regions.

Full reference and link: K J Fitzsimons, S Mukarram, L P Copley, S A Deacon, J H van der Meulen. Centralisation of services for children with cleft lip or palate in England: a study of hospital episode statistics. BMC Health Services Research. 2012;12:970-974.