Depending on your or your child’s individual needs, you may meet a range of healthcare professionals through your cleft journey. The teams listed below all play an important role in supporting patients and families.
Cleft administration team
Our admin team work behind the scenes to make sure everything runs smoothly. We also have our waiting list officer who works closely with our team.
You may speak with them:
- Over the phone when making a patient referral
- If you ring regarding a query about your / your child’s care
- To arrange/ amend/ cancel appointments in clinic
- To advise you about your / your child’s upcoming surgery
- Regarding the in-house database/ Cleft National database (CRANE), including consent
Each team member has a distinctive role within the service, however they are all able to provide a level of core crossover as and when required.
Cleft nurse specialists
We have 3 specialist nurses who work across both hospital and community settings. They are the main point of contact for patients and families following diagnosis. They will work closely with the wider cleft team to coordinate care throughout your cleft journey.
You or your child will be allocated a named nurse to oversee their care and provide support throughout their cleft journey. If you have any questions or concerns, please contact your cleft nurse who will be able to assist you.
Clinical psychologists
Our psychology team help to support patients and families throughout their cleft journey.
Issues the psychology team can support with include:
- Concerns with appearance
- Reacting to other people’s responses
- Worries about hospital treatments
- Dealing with bullying / teasing
- Making decisions about treatments
- Any of concerns regarding cleft lip and palate.
Consultant cleft and plastic surgeons
Our surgeons are responsible for patient care, planning treatment options and performing surgical interventions. You will meet with a consultant before any surgery is planned. They will examine you or your child, explain the procedure and answer any questions you may have.
Dental team
Paediatric dentist
The role of the paediatric dentist is to try and help you prevent dental diseases by encouraging your child to eat and drink the right types of foods and drinks. 
The paediatric dentist will work with your own dentist to maintain the teeth and gums so that the orthodontist, speech therapist and surgeon can treat your child effectively.
You will be encouraged to attend your family dentist for regular appointments as well as seeing the dentist at your cleft clinic appointments.
Restorative Dentistry
The consultant in restorative dentistry works closely with your local family dentist to ensure the teeth are as healthy as possible, as well as working closely with the orthodontist and Surgeons to position teeth in the best position to facilitate replacement or re-shaping of the teeth to provide a beautiful smile. Patients born with a cleft lip and / or palate often have dental anomalies, usually in the form of missing, misshapen or even sometimes extra teeth (particularly in the cleft site). The Consultant in Restorative Dentistry is a specialist in re-shaping teeth with composite bonding, and replacing teeth with dentures, bridges or implants.
Ear, nose and throat surgeons
The ear, nose and throat service (ENT) team works closely with some of the cleft patients. There can be associated problems with hearing and issues with  glue ear. In children with a cleft palate diagnosis. All patients with a cleft palate receive a referral into the ENT service for routine reviews during their early year of development.
Genetics team
You may be referred to clinical genetics if:
- Your child has a cleft with other medical or developmental concerns (most clefts occur by chance and are isolated and not associated with other separate medical problems).
- You have more than one close relative with a cleft.
- You are planning another pregnancy and want to discuss the chances of a cleft occurring.
- There is a known genetic condition in your family that causes clefts.
If genetic testing is offered and you decide to go ahead, a small blood sample may be taken – sometimes this can be coordinated with surgery. Please note, genetic tests usually take several months to come back. If the genetic testing identifies any findings, a member of the genetics team will discuss the results with you.
Medical photographer
Medical photography is undertaken in all clinics to keep patient records up to date and accurate. 
Each time your child comes to see the cleft team, the photographer will also be present. Patients and families will be asked for consent to have photographs taken
The pictures are incorporated into medical case notes to help in the planning and assessment of clinical treatment. 
Photographs could be required of the following areas:
- Face and inside the mouth (palate) – for the surgeon to check the progress of a cleft repair
- Teeth – for the orthodontist and the paediatric dentist to assess oral health and decide on a course of treatment.
- Hands and feet – for the geneticist to find out more about the patient, and perhaps pick up subtle clues that can help with a diagnosis.
Additional photographs may be taken with a camera that takes a 3D image of the patient’s face.  This can help the team look at any facial changes or growth.
Orthodontist
An orthodontist uses braces to move the teeth. This can be required at multiple points throughout adolescence and into adulthood. If your child requires an alveolar bone graft (ABG), braces can be needed beforehand to help move the teeth in preparation for the surgery.
We aim to assess every person with a cleft at the age of 12 to find out whether they might need braces. Often braces happen as a slightly older teenager, and the teeth must be clean and decay-free.
Braces aim to straighten the teeth and can also be used in combination with jaw surgery in adulthood. Adult patients who do not require jaw surgery, may still qualify for braces if they are needed to help with a problem caused by their cleft
Research team
Research plays an important role in helping us improve care and treatment for people born with a cleft lip and/or palate. Our research team supports studies that aim to increase understanding of cleft conditions, improve patient outcomes and enhance the care we provide to patients and families.
Speech and language therapists
We have a large team of speech and language therapists working with the cleft service, each covering a different patch within the area our service covers.
If your child has a cleft palate, or speech problems related to how well their palate is working even when there is no cleft palate, they will monitor their speech development regularly.
They can tell you about:
- Speech development
- What can happen to speech when someone’s palate is not working well enough
- How to help your child’s speech development
If it is decided that your child would benefit from a video fluoroscopy (talking x-ray assessment) then this will be arranged in clinic.
