Some form of cleft occurs in up to 1 in 500 live births. The overall management of a patient with cleft lip and palate is a team effort involving orthodontists, ENT surgeons, speech therapists, paediatricians and maxillofacial surgeons, as well as plastic surgeons, all of whom should have expertise in this specialist field. In the UK there are now designated centres where the surgery is concentrated to result in surgeons treating approximately 40 new babies each per year or more. This change to high volume operators came about following the Clinical Standards Advisory Group report on Cleft Care in the UK. Now all centres are working towards collecting data for intercentre audit and ultimately comparison of treatment protocols will enable UK Cleft Centres to contribute to the scientific literature.

Facilities need to be available for the continuing care of these patients until adult life.  Part of the team development following the redesignation of Cleft Centres has been the expansion in support provided by specialist nurses and clinical psychologists so that families are better supported.  The burden of care is reduced by having truly multidisciplinary clinics so the trips to hospital are reduced and care is discussed by the teams involved.  Local speech and language therapy, hearing advice and orthodontics continue to reduce the need to travel.  Travel is mostly for surgery with as much care provided as close to home as possible.