Hundreds of Bristol patients harmed by cleft treatment backlog

The review made 10 recommendations for the Bristol hub and wider South West clinical network

More than 100 young people with cleft lips or palates have been "harmed" because of huge delays in treatment at Bristol Children's Hospital, a review has found.

The backlog resulted in two patients suffering "severe" harm, a health board meeting heard.

A report presented to the meeting said concerns about the cleft service were already apparent before the pandemic.

The hospital trust has apologised and taken steps to address the issue.

The Local Democracy Reporting Service (LDRS) said the University Hospitals Bristol & Weston NHS Trust (UHBW), which runs the service for the South West region at the children's hospital and Bristol Dental hospital, has hired more medics and has increased surgery sessions and speech and language therapy.

A report to the trust board said concerns about the cleft service from limited operating theatre capacity, pressure on speech and language therapy teams and long-term sickness of key clinical specialists were already apparent before the Covid-19 pandemic made delays worse.

It said the impact on 268 patients waiting for treatment and their families was assessed between 2020 and 2022 in a major exercise called a "harm review".

'Increased risk of complications'

A total of 118 of these were deemed to have experienced some degree of harm - two "severe", 91 "moderate" and 25 "minor" harm - plus another 57 who were at "greater risk of coming to harm" subsequently as a result of the problems.

The report said: "Due to the clinically time-sensitive nature of cleft treatment, these delays can result in increased risk of complications for patients."

It said these included children who did not have cleft palate surgery until after they were 13 months old, which put them at higher risk of developing problems with speech, feeding, weaning and socialising.

NHS guidelines advise that cleft lips should be treated by six months of age and cleft palates by 13 months.

UHBW chief medical officer Stuart Walker said after the meeting: "I would like to express my sincere regret that some of our patients and their families have been affected by the delays in the South West Cleft Service.

"We have undertaken a thorough review of this service and have apologised to those patients and families we have identified through this process.

"This is not the experience we wish for anyone in our care and we are committed to do all we can to support them as they continue their treatment.

The cleft team is contacting all 150 patients who came to moderate or severe harm or are at greater risk of harm to discuss the findings and their treatment.

Patients have been advised to contact the service if they have any concerns.