§ Mr. BoswellTo ask the Secretary of State for Health if, in reviewing cleft lip and palate services, he will have regard to(a) the desirability of maintaining different clinical approaches, (b) travelling times to centres of excellence for parents and their children and (c) the practicability of providing adequate specialist nursing support services close to the parents' home.[110010]
§ Mr. Denham[holding answer 14 February 2000]: Under the new arrangements all centres will be required to participate in national, inter-centre audit. This will, for the first time, collect clinical data on an equivalent basis and allow comparisons to be made of the effectiveness of centres and different techniques. It will be a vital tool in supporting practice and the continuing training needs of clinicians. Arrangements for the appointment of surgeons in designated cleft lip and palate centres, including the selection criteria, will be a matter for employing National Health Service trusts. Those applying for posts will be required to demonstrate evidence of their skills and expertise regardless of surgical technique.
536WThe new services will work on a hub and spoke basis. Surgery and other specialised elements of care will be provided at the main centres, but many aspects of care will continue to be provided locally, in close liaison with the main centre. We accept that some patients and their carers will need to travel further for some aspects of their care because it is not possible for the highest standards of care to be provided at every hospital which has previously carried out cleft lip and/or palate surgery.
It will be for each cleft centre to ensure that patients have access to specialist nursing services. This might be provided on an outreach basis from the main centre or by nurses with specialist skills in spokes working in accordance with agreed protocols.