UPDATE
Following our concerns about proposed cuts to specialist cleft surgery training, we are pleased to share that funding has now been secured for future cleft surgery fellows.
This is a significant and welcome development for cleft training and for the long-term sustainability of the specialist surgical expertise that cleft services rely on. While there will be some changes to how the programme is delivered, securing continued funding for a cleft surgery fellowship is an important step in protecting the training pipeline needed to maintain that expertise in the future.
CLAPA would like to thank everyone who supported our campaigning and advocacy on this issue, as well as the dedicated work of Louisa Fergusson and members of the cleft TIG committee, who have worked tirelessly to secure the future of this important training programme.
Louisa Fergusson, Chair of the Cleft TIG, said:
I’m delighted that funding has been secured for a cleft surgery fellow in 2027 and thank CLAPA for their work campaigning and advocating to protect cleft training. The fellowship gives surgeons dedicated time to develop the specialist skills they need to care for children and adults born with a cleft. We’re now working through the recruitment arrangements, and the fellow will follow the existing TIG curriculum with oversight from our committee. This is good news for the future of cleft surgical care and for the people who rely on it.
CLAPA will continue to monitor developments and work with partners across the cleft community to help ensure specialist training remains protected for future generations.
CLAPA is still waiting to speak directly to NHS England regarding cuts to specialist training fellowships for cleft surgeons, after receiving a short response from the Government to our letter of concern.
Despite repeated attempts from Lachlan Bruce, our policy and campaigns manager, there is silence from NHS England on the proposed way forward after cuts to Training Interface Group (TIG) fellowship budgets.
TIG fellowships are specialised NHS training programmes, which take place at the end of a surgeon’s training – including plastic surgery, and oral and maxillofacial surgery for trainee cleft surgeons.
The Royal College of Surgeons warned earlier this year – through an article in The Telegraph – that if no new surgeons enter the TIG training programmes it could lead to fewer NHS surgeons being able to take on complex work, including cleft surgery, when current surgeons retire.
It doesn’t address the core concerns we have raised around workforce sustainability or patient impact and leaves a significant gap at a national level.
CLAPA contacted The Telegraph and a further article was published highlighting the effect specifically on cleft treatment, quoting our chief executive Claire Cunniffe, who said, “specialist training was essential to maintain standards of care”.
We wrote to Wes Streeting, former Secretary of State for Health and Social Care, highlighting the impact to cleft care of a removal of TIG fellowships.
The Government sent a short response, confirming the decision by NHS England to discontinue central funding of the salary support component of the TIG programme, and “redirect resources to regional workforces”.
Lachlan Bruce, CLAPA’s Policy and Campaigns Manager, said the response includes a broad commitment that NHS England is ‘considering’ how to support highly specialised areas like cleft in future, “but provides no detail, timeline, or clear replacement pathway”.
Following that letter, at the start of May CLAPA directly contacted the Chief Executive on NHS England – seeking to raise our concerns with him and requesting the opportunity to discuss the changes with the relevant parts of NHS England. We have yet to receive a response to our concerns.
We will continue to push for a more detailed response – to ensure the voice of the cleft community is considered when decisions about the future of surgical training are made.
CLAPA believes the loss of the structured national training route risks weakening the cleft surgical workforce and narrowing the future training pipeline.
Our statement on the situation says: “Any dilution, fragmentation or uncertainty in training pathways risks undermining safety, long-term outcomes, ability to meet the requirements of the National Service Specification and continuity of care”.
Lachlan added: “While the Government’s response notes that regions or providers can continue TIG-style training using the Joint Committee on Surgical Training curriculum, this effectively shifts responsibility away from a coordinated national approach against what is best practice for cleft care.
“It doesn’t address the core concerns we have raised around workforce sustainability or patient impact and leaves a significant gap at a national level.
“It’s not an adequate answer and doesn’t take account of the concerns we hold, which is why I’ve continued to request a meeting with NHS England to discuss the details of any replacement to TIG fellowships.
“We will continue to push for a more detailed response – to ensure the voice of the cleft community is considered when decisions about the future of surgical training are made.”
Read: “CLAPA responds to cleft surgery training cuts”