Information about how the cleft service is running during the recovery phase of the Covid19 pandemic

To all our patients and families,

With the rising number of cases of coronavirus we are having to change the way our services run in order to keep our patients and families safe and allow resources to be used most effectively during the pandemic.  

Surgery for children

Cleft surgery for children is running at Birmingham Children’s Hospital but at a reduced capacity. We are currently operating on urgent cases which have been defined by the Royal College of Surgeons; this means children having cleft palate repair who are 12 months or older, children for cleft lip repair who also have a cleft palate who are 7 months or older, children needing an alveolar bone graft who are 9 years or older and children waiting for speech surgery who are 4 years 11 months or older. We are booking patients based on the urgency with which they need to be done. We are making these decisions based on the type of surgery you/your child needs and your/your child’s age as well as any additional medical problems that may make it safer to postpone the surgery (exactly as we would under normal circumstances). This might mean that you are not in the same place on the waiting list as you were before Covid-19.

Once we have a date when we will be able to carry out your/ your child’s surgery we will contact you by phone and you will receive a letter; we may only be able to give you 1-2 weeks notice. You will be given an appointment with the preadmission team who will contact you by telephone to make sure you/your child is fit for surgery. The preadmissions team will arrange for you to bring your child into the hospital within 72 hours of their surgery to have a test for Covid-19; this will be done by swabbing the back of yours and your child’s nose with a cotton bud.

If you, your child or any member of your family has symptoms of Covid-19, or you think you have had contact with someone who is infected with Covid-19 it is essential that you let us know. Further information about coronavirus symptoms can be found here: https://www.nhs.uk/conditions/coronavirus-covid-19/symptoms/

If you, your child or any member of your household has symptoms or have been in contact with someone who has Covid-19, you/ your child tests positive for Covid-19 or your child is not able or willing to have a test for Covid-19 we will postpone your/your child’s operation.

Birmingham Children’s Hospital Trust is not asking patients to shield (remain at home with contact only amongst household members) before surgery. Currently, the trust policy is that only one adult will be able to come with you/your child when they come in to hospital. You can swap over, for example, if one parent needs to return home to look after other children, but this must be done outside the hospital. In line with government guidance we ask that you wear a face covering while you are in the hospital and follow hand-washing and social distancing guidance.

We understand that some of you may have concerns about you/ your child having surgery at this time. If you would like further information about Covid19 and surgery please see the guidance from the Royal College of Surgeons https://www.rcseng.ac.uk/coronavirus/recovery-of-surgical-services/tool-3/

Surgery for adults

Due to the greater impact of Covid-19 on adult services, we are not able to offer surgery for adults at the current time. We understand that this might be difficult for those of you waiting for surgery and thank you for your patience. We will keep this page updated as we get more information.

Out-patient clinics for children

These include all appointments with cleft and maxillofacial surgeons, ENT Cleft surgeons, hearing tests, orthodontics, dentists, psychology and speech and language therapists.

We are running both face-to-face and virtual (video or telephone) appointments for both children in Birmingham Children’s hospital. We will only bring you/ your child into the hospital if we cannot assess or manage your/your child’s condition at home so we will often offer a virtual (video or telephone) appointment in the first instance.

Face-to-face appointments

If you are offered a face to face appointment and you or any member of your household has symptoms of Covid-19 or have had contact with someone who is infected with Covid-19 please do not come to the hospital. Stay at home and let us know that you will not be coming. Please do not arrive at the hospital more than 5 minutes before your appointment time so that the waiting room does not become crowded and in line with government guidance all adults and children over 11 years of age should wear a face covering in the hospital. Please observe social distancing and hand washing guidance in the hospital.

To prevent the spread of infection, we are trying to limit movement around the hospital. You may be asked to remain in one room and different professionals may come in to see you in the same room instead of you moving between different rooms as before the pandemic. Staff will be wearing appropriate personal protective equipment (PPE) to keep you and themselves safe. They may be wearing masks, aprons, gloves and visors or goggles.

Virtual appointments

We may offer you a “virtual” clinic appointment via telephone or video link. You will be sent a letter 2 weeks before with the date and time of your appointment. This appointment will replace your face-to-face appointment and unless you bring up a concern that needs to be managed face-to-face, we will not ask you to come into the hospital to repeat the appointment.

For telephone appointments, please make sure that your phone is on and you can hear it, you have sufficient battery and are in a place with good telephone reception at the time of your appointment. We will try all telephone numbers that we have on record for you. If you think that we might not have the correct telephone number for you please email your telephone number along with the name and date of birth of the patient to bwc.cleftservices@nhs.net for children or jenniferdavis2@nhs.net for adults.

If you would like information about video appointments at Birmingham Children’s Hospital, please click on the link below: 

West Midlands Cleft Lip and Palate Team Virtual Appointment Guidance [pdf] 593KB

For patients in the adult service, information about video appointments will be sent out with the clinic letter.

Speech therapy

If your baby is waiting for palate repair, you may be contacted by telephone or video and given some advice about how you can encourage your child’s speech development. You will meet a speech therapist when you bring your child to their clinic appointment after their palate has been repaired.  Most speech therapy appointments are being carried out virtually. You can also find information about games you can play with your baby to help speech development below.

Please see our Cleft Lip and Palate leaflets for information about how you can encourage your child’s speech, before and after palate repair.

New babies

If you are pregnant or have just delivered your baby, congratulations and welcome to the Cleft service. You will be contacted by a Cleft Nurse Specialist shortly after your baby’s cleft has been diagnosed. They will visit you in the hospital or at home to assess your baby and provide support within a few days of their birth (or of the cleft being diagnosed if this is later). They will be able to provide you with specialist feeding bottles and other equipment at this visit. 

You will be asked to bring your baby to the hospital so you can meet your surgeon. Please see the information above about “face-to-face appointments”. We are performing surgery for babies with cleft at this time, see information about “surgery for children”.

Out-patients appointments for adults

Due to the greater impact of Covid-19 in adults, we are not able to offer out-patient appointments at the moment. If you have an urgent query please contact the cleft team (details below). In an emergency, please present yourself to your A&E.

Contact details

Please read the above information before contacting the cleft team. I’m sure you understand that all our staff are extremely busy right now and it may take some time to get back to you.

Birmingham Children’s Hospital

bwc.cleftservices@nhs.net

0121 333 8235 (Natalie Matthews - Cleft Service Manager)

Queen Elizabeth Hospital

jenniferdavis2@nhs.net

0121 371 4991 (Jennifer Davis – Cleft Team Secretary)

We understand that the disruption to the service is stressful and difficult and we appreciate your patience and understanding during this time. The situation is changing rapidly and we will aim to keep this webpage updated, including details of changes to the availability of surgery and out-patients appointments.

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