{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T04:43:37Z","timestamp":1777524217868,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2018,1,23]],"date-time":"2018-01-23T00:00:00Z","timestamp":1516665600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Since the implementation of centralized services in the United Kingdom for those affected by cleft lip and\/or palate (CL\/P), several studies have investigated the impact of service rationalization on the delivery of care. While large-scale quantitative studies have demonstrated improvements in a range of patient outcomes, and smaller studies have reported on the benefits and challenges of centralization from the views of health professionals, little research has attempted to capture the patient perspective. Furthermore, few studies have investigated the views of adult \u201creturners\u201d who have undergone treatment both pre- and postcentralization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Qualitative data relevant to the subject of this article were extracted from 2 previous larger studies carried out between January 2013 and March 2014. A total of 16 adults born with CL\/P contributed data to the current study. These data were subjected to inductive thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The findings suggest that centralization of CL\/P services has considerably enhanced the patient experience. Specifically, the overall standard and coordination of care has improved, service delivery has become more patient centered, and access to professional psychological support and peer support has greatly improved patients\u2019 capacity to cope with the associated emotional challenges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The data collected provide additional insight into the impact of centralization from the perspective of a largely unexplored patient population. In combination with other literature, these findings are also relevant to future efforts to centralize other specialist services around the world.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1055665617744064","type":"journal-article","created":{"date-parts":[[2018,1,24]],"date-time":"2018-01-24T09:57:51Z","timestamp":1516787871000},"page":"676-681","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Centralization of Cleft Lip and Palate Services in the United Kingdom"],"prefix":"10.1177","volume":"55","author":[{"given":"Nicola Marie","family":"Stock","sequence":"first","affiliation":[{"name":"Centre for Appearance Research and The Cleft Collective, University of the West of England, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamza","family":"Anwar","sequence":"additional","affiliation":[{"name":"Regional Coordinator for the East of England, Cleft Lip and Palate Association, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan R.","family":"Sandy","sequence":"additional","affiliation":[{"name":"Dean of the Faculty of Health Sciences, University of Bristol, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nichola","family":"Rumsey","sequence":"additional","affiliation":[{"name":"Centre for Appearance Research, University of the West of England, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,1,23]]},"reference":[{"key":"bibr1-1055665617744064","doi-asserted-by":"publisher","DOI":"10.1111\/ocr.12109"},{"key":"bibr2-1055665617744064","first-page":"189","volume":"30","author":"Antonarakis GS","year":"2013","journal-title":"Community Dent Health"},{"key":"bibr3-1055665617744064","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"bibr4-1055665617744064","unstructured":"British Psychological Society. 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