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CSAG II Research into the impact of the reorganisation of cleft services (NIHR)

CSAG II Research into the impact of the reorganisation of cleft services (NIHR). Jonathan Sandy. CSAG I – why did it happen?. Royal Colleges Department of Health Clinician Groups Parent and Patient Groups. Jonathan Sandy.

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CSAG II Research into the impact of the reorganisation of cleft services (NIHR)

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  1. CSAG II Research into the impact of the reorganisation of cleft services (NIHR) Jonathan Sandy

  2. CSAG I – why did it happen? Royal Colleges Department of Health Clinician Groups Parent and Patient Groups Jonathan Sandy

  3. Evidence – not much but Eurocleft –Comparison of 6 European Centers Data published in 1991

  4. The Clinical Standards Advisory Group Cleft Lip and Palate

  5. Process data • Outcomes • Patient and Parent views

  6. Data is prior to 1998 CSAG Twelve Year Olds I II III

  7. Alveolar Bone Grafting CSAG Oslo n=157

  8. Data is prior to 1998 UK CSAG

  9. Speech Intelligibility 5 year olds 12 year olds Normal 19% 47% Different 30% 34% Provokes Comment 32% 15% Unintelligible 19% 4%

  10. Patient and Parent Satisfaction

  11. Published in 1998

  12. CSAG • Compelling evidence from a detailed and meticulous study • Recommendations unanimous • Recommendations accepted by Government • Recommendations consistent with centres from abroad

  13. Recommendations • 57 cleft units to be concentrated in 8-15 centres

  14. Audit from 3 Regions Data from 2003

  15. Audit from 3 Regions Data from 2003

  16. Mike Wake Annals of The Royal College of Surgeons Increased volume = Improved Outcomes

  17. Research Strategy • CFSGBI – Research and Audit Leads • Workshop in RCTs – March 2005 • Funding opportunities – Healing Foundation

  18. Research leads Andy Ness SteveThomas Lifecourse Determinants Nutrition and Cancer

  19. The Research Team Sam Leary Charlotte Atkinson Andrea Waylen Alex Griffiths Martin Persson Statistics Nutrition Psychology StatisticsProject manager More posts with NIHR programme…

  20. NIHR programme • Workshops and strategy • Systematic reviews • Care and outcomes for cleft children

  21. CSAG-II • Concentrate on 5 year olds for outcomes • Speech, hearing, oral health, dento – alveolar relations etc • Parental and team questionnaires • Process and infrastructure

  22. Funding • Bill Shaw $6 million NIH • Andy Ness £3 million NIHR • Healing Foundation £2 million • MCRN support costs – Sally Davies

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