Statement: Centralisation of Cleft Surgical Services in Scotland

September 8, 2016

On 7th September 2016, a debate was held in the Scottish Parliament. This concerned the decision by the NHS board chiefs on 21st June to approve the recommendation that cleft surgical services in Scotland be centralised to a single site in Glasgow. This recommendation was made by the National Specialist Services Committee following a long-term consultation which CLAPA has been heavily involved with.

This debate discussed a motion brought forward by Miles Briggs entitled ‘Opposition to Centralisation of Cleft Lip and Palate Surgery’.

Watch the video of the debate on the Scottish Parliament website

A Statement from CLAPA CEO Dr. David Stokes

CLAPA is the only national charity that seeks to support everyone affected by cleft in the UK – a condition that affects around three new families a day. As an organisation we are heavily involved in developing peer support for our community, and provide this by means of family groups, trained peer support volunteers and through local volunteer Branches.

Our Scottish community is supported by CLAPA by means of a full-time Senior Regional Coordinator, Gillian McCarthy, a part-time Support Officer, Melanie Skinner, and a part-time Intern.

Background

The consultation in question covers a proposal to change the delivery of the specialist cleft surgical service for Scotland. It was entirely managed by NHS Scotland’s National Services Division – led by David Steel and co-authored by representatives of the two services affected – Colin Briggs for NHS Lothian and Catriona Renfrew for NHS Greater Glasgow and Clyde. The process also included a stakeholder consultation group of which CLAPA was a part, represented by Gillian.

The proposal was raised to develop a more sustainable, resilient and consistent quality of care for all patients in Scotland, and to promote closer and better working.

It is important to note that the process is related specifically to surgical services, with all other elements of the cleft care pathway to continue to be provided as close to home as possible. It was felt that the current service, with two surgical services on separate sites – including a single-handed surgical service in Edinburgh – was no longer a resilient or sustainable model of care delivery. The options presented were for the creation of a single centre based at either of the sites or to maintain the status quo. There was/is to be no reduction in the number of surgeons in the proposal, nor any loss of other expertise.

CLAPA staff have been closely monitoring the consultation, attending most of the meetings, and report that the process has been completely transparent and open, with excellent engagement with the affected community. As a third-party organisation, working on behalf of the affected community, it is in our interests that the best outcome is achieved for our members, and we certainly have no complaints regarding the process or evidence collected.

Our View

With regards to CLAPA’s view of the process and proposals, we feel that our responsibility is to represent the whole community across Scotland, including all sides in this passionate debate. Certainly there are CLAPA supporters who are both for and against this proposal. Therefore, we have taken the decision that we must retain a neutral position, trusting the process to determine the appropriate outcome, a position we still maintain.

Ultimately this is an operational decision for the NHS, and must be made by the relevant experts, using the best available evidence, and on the basis of best patient care. That being said, following the final decision of the review, CLAPA will endeavour to ensure a careful oversight of any new arrangements that come into place to ensure that our community is not significantly disadvantaged.

I hope that the information provided above is of help in understanding our view of the process.

Dr David Stokes

Chief Executive Officer

Cleft Lip & Palate Association (CLAPA)