Private and Non Cleft Team Services

There are many reasons why patients born with a cleft may consider private treatment. This page is intended to help you understand the pros and cons of private treatment, and to help you come to a decision which is right for you.

Outside of the NHS Cleft Teams, information about specific procedures and treatments will differ between providers, so CLAPA isn’t able to provide medical information about treatment from private practitioners. Instead, this page aims to give you a good overview of the things you should keep in mind when seeking private treatment, or treatment from outside NHS Cleft Teams.

Jump to: Information for Private Practitioners

Information for Patients

Talk to your NHS Cleft Team first

If the procedure or treatment you are opting for is cleft-related, it is likely that it will be available free of charge on the NHS. Even if it is not, we strongly recommend you discuss any potential private treatment with your Cleft Team so they can make sure that it is indeed the right thing for you.

NHS Cleft Teams see hundreds of cleft patients each year. This means they are well placed to advise on whether there are any cleft-specific issues that it would be important for anyone providing treatment to take into account.

Do not feel guilty, or worry that the team will be offended by you seeking treatment elsewhere. NHS teams understand that patients may choose private treatment for a huge number of reasons. Some may be able to recommend private clinicians in the area with appropriate experience.

If you’re looking into private treatment because you’re unhappy with your current Cleft Team clinician(s), you are entitled to seek a second opinion from a different specialist within your team (if your team has more than one clinician in that specialty i.e. surgery), or from another Cleft team. The clinicians in the Cleft Teams are cleft specialists, and it is unlikely you will find the same level of expertise in general private practice. Find another team here (https://www.clapa.com/treatment/nhs-cleft-teams/) and get in touch to ask about arranging a consultation. Please note that although you are entitled to seeking a second opinion, it may not always be possible for you to receive treatment in a different team.

Make sure your expectations are realistic

Surgery and other treatments are not a fix-all. There is always a risk that you’ll find yourself disappointed with the results, even if the procedure is a success. You may also find that although the way you look has changed, the way you feel has not. It’s important to understand what your hopes and expectations are for the treatment you’re seeking, and to manage these appropriately. The psychologist with your Cleft Team can help talk you through this and make sure you’re fully prepared, even for private treatment.

It is also important to understand the limitations of modern healthcare. Modern healthcare can do a lot of things, but it may not be as precise, risk-free, satisfying or successful as we might hope. It’s possible the treatment you seek may not achieve what you hope it will, or that there is nothing more that can be done.

If your Cleft Team are firm about not performing any more surgery for a particular issue because they believe nothing more can be done, this may be disappointing. However, if you want to seek surgery from elsewhere, we would ask you to carefully consider the risks in going against your team’s recommendations. Your Cleft Team will have a good understanding of your medical history, individual needs, and the particular issues involved with treating a patient with a cleft. A private practitioner may not have this understanding, and may make recommendations based on incomplete information. If you’re unhappy with what your Cleft Team have told you, we would recommend seeking a second opinion from another team in the first instance before considering private care.

Check the qualifications of the practitioner

Most healthcare professions in the UK are protected titles. This means that a practitioner must be registered with a recognised professional body to be able to call themselves a practitioner and to practice in the UK, including in private practice. These professional bodies include the General Medical Council, Nursing and Midwifery Council, Health & Care Professions Council (HCPC), etc. You can check the registration status of your practitioner here: www.hcpc-uk.org.

If somebody has the title ‘Dr’, this does not necessarily mean they are a medical doctor. Some people who use the title ‘Dr’ may have a non-medical professional doctorate degree for a different clinical profession (like dentists and clinical psychologists). Others may only have an academic PhD, which does not relate to clinical practice. To make things even more confusing, whilst surgeons who train in the UK do have a medical degree (so were once called ‘Dr’), they revert to using the title Mr/Mrs/Ms once they complete their surgical training due to tradition.

A good clinician will make their job title and qualifications clear, and will not be offended if you ask them to clarify this.

Some professions selfregulate

Some practitioners such as beauticians, who may do procedures such as lip fillers and lip tattooing, or nutritionists who may give dietary advice are not health professionals and are not required to be registered with the HCPC.

When considering private treatment, it is particularly important that you understand this, and do due diligence to establish the credentials of the person and/or company looking to undertake your procedure. In these professions, there are vast differences in the amount of training people have had, so you want to be sure you are going with someone reputable who has done your procedure many times before.

Some local authorities regulate beauty salons, many others do not. Contact your local authority if you have any questions about a particular beauty salon.

Ask about the practitioner’s experience with cleft

Some treatments are more complicated or may need to be done differently when somebody has been born with a cleft. Make sure you feel comfortable that the practitioner understands (and is experienced with) cleft. You might want to ask them how many patients with a cleft they personally have treated in the past 2 years. Whenever possible, get a recommendation from your Cleft Team.

Think about follow-up care

Ensure that you understand and are happy with the follow up care you will receive and what is included in the cost of your treatment. This includes what may happen if things don’t quite go as planned, as you may have to pay for extra appointments. Ask what you should do if you start experiencing a problem suddenly, or out of hours, as there may be situations where it is best to attend an A&E department.

Private clinics may not be impartial

Unlike the NHS, private practices are generally run as businesses. If you are on the fence about treatment, it is often (not always) in their interests to sell you treatment. Give yourself time and space to carefully consider what is being offered, and talk through your options with someone you trust.

Additionally, many private patients report having issues/treatments suggested on top of those they had come to discuss (e.g. chin/cheek implants, botox), even if this not something they had never thought about before. In the moment, this might feel very personal, you may think you must have a real issue in this area for them to mention it at all, but be mindful that this happens often enough to have a name: upselling.

If a clinic mentions an issue you’d never been bothered about before, be aware this could be driven by a business model rather than a ‘defect’ you didn’t know you had.

Information for Private Practitioners

CLAPA is regularly approached by professionals offering their services to people who have been affected by cleft. CLAPA follows the directions of the NICE Guidelines in England and Wales, and of Cleft Care Scotland, which advises best practice is for patients to visit their Cleft Team.

The following guidelines are for anyone wishing to offer free or paid services to the cleft community.

  • CLAPA is unable to endorse or advertise any services which are not provided by the NHS Cleft Team. The service specification for cleft in the UK stipulates that cleft care is to be carried out by NHS Cleft Teams. Therefore, CLAPA will direct people to the Cleft Team for any medical advice. We won’t advertise services that fall outside of this unless endorsed by the Cleft Team for the region(s) in which you offer services. We also do not allow others to advertise these services within our Facebook groups. This applies to both free and paid services.
  • The NHS Cleft Teams are best placed to offer advice and recommendations. If you have a service which you think would be useful for our community, link up with your NHS Cleft Team. If they too feel that it is a useful addition to the services the cleft team offer, ask them to consider referring to your service where appropriate.
  • Fundraising partnerships with private practice need to be transparent. As a private practice practitioner, you may wish to support CLAPA financially, and we certainly welcome your support. However, please be aware that we cannot advertise your services or accept donations which may pose a conflict of interest with this policy. Any donations made to CLAPA from private practitioners should be given freely and without seeking any preferential treatment from CLAPA or its community in return. CLAPA reserves the right to refuse support or sponsorship from individuals or organisations at its discretion.

If you have any questions regarding this policy, please contact the Adult Services Coordinator, Kenny Ardouin at [email protected].

CLAPA would like to acknowledge and extend its thanks to Dr Jess Hare, Principal Clinical Psychologist, National Cleft Surgical Service for Scotland for her contributions and assistance in developing this policy.

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