Owen Lake, clinical negligence specialist, the questions parents are asking about treatment at the Southwest Cleft Service

Families whose children have been treated by the Southwest Cleft Service at University Hospitals Bristol and Weston NHS Foundation Trust have raised concerns about delays, communication, and the quality of care. These concerns follow a 2023 independent harm review, which found systemic failings and identified children who had been harmed or placed at risk during a critical period for treatment. We understand that many parents may now be questioning the care their child received and what this means for them moving forward.

We spoke to legal specialist Owen Lake, who is supporting affected families, to answer some of the questions parents may now be asking.

There’s been a lot of concern around the Southwest Cleft Service. What sits behind that?

Owen: The service has been under scrutiny for a number of years. A review looking at care between 2020 and 2022 found that 118 young people had suffered harm or were at risk, largely linked to delays. In cleft care, timing is critical, procedures are planned around a child’s development, and delays can affect speech, eating, and long-term outcomes. What we’re seeing now is that families are still coming forward with questions about those delays and how care has been delivered.

When parents come to you, what usually prompts them to start asking questions?

Owen: It can be different for every family. Sometimes it’s a feeling that something isn’t right, a procedure hasn’t worked, or delays keep happening. In other cases, it’s information that comes to light later, or being told that care might have been handled differently.

What kinds of issues are parents raising?

Owen: There are some clear patterns.

• Repeated or significant delays outside recommended timeframes
• Changes to treatment plans that weren’t properly explained
• A lack of continuity, with children seeing different clinicians

It can make the overall experience feel quite fragmented. Often, it’s only later that parents start to question whether they fully understood what was happening at the time.

In one of the cases you’re supporting, these issues come through clearly. Can you explain what happened?

Owen: Yes, in this case, a young girl had already undergone a bone graft in 2022 which wasn’t successful. A second procedure was then significantly delayed and eventually took place in December 2024. That surgery was carried out at a private hospital by a retired surgeon. The family understood that bone would be taken from the child’s knee, which is a common approach.

But the surgery didn’t go to plan?

Owen: No, during the procedure, a product derived from donor bone was used. The parents hadn’t been told this would be used and hadn’t consented to it. They only found out later at a follow-up appointment, where they were also told the procedure hadn’t been successful. Situations like this can leave families with a lot of unanswered questions, particularly about what they were told beforehand.

What should parents expect in terms of information before surgery?

Owen: Parents should be given a clear explanation of:

• What the procedure involves
• What materials may be used
• Why those decisions have been made
• What the alternatives are

That’s a fundamental part of informed consent.

There’s also been expert criticism in that case. What has that focused on?

Owen: The independent expert evidence raises a few key concerns:

• The use of cadaver-derived material, which has been described as not standard UK practice for this procedure
• The length of the delays
• The lack of continuity in care

Taken together, those points raise questions about how the treatment was managed.

If a child’s treatment was delayed or moved elsewhere, is that always a cause for concern?

Owen: Not necessarily, there are times when services need to use other providers, particularly when there are capacity pressures. But when that happens, it’s really important that families are given clear information about what’s changing, where treatment will take place, who will carry it out, and what the overall plan is.

Are you seeing other families come forward with similar concerns?

Owen: We’re aware that other families may have had similar experiences, particularly during the period when delays were at their worst and some procedures were being outsourced. For many parents, hearing that others have similar concerns can be an important moment.

What would you say to a parent who is starting to question their child’s care?

Owen: I’d say that’s completely understandable, you don’t need to be certain that something went wrong to ask questions. Many families come to us because they want a clearer picture of what happened and whether the care their child received was in line with what would normally be expected.

How can speaking to a specialist help?

Owen: We’ll go through your child’s care with you, step by step, what happened, what you were told at the time, and anything that’s been playing on your mind since.

A lot of parents come to us because something doesn’t quite sit right, but they’re not sure why, or whether it’s something they should be concerned about. That’s completely understandable. You don’t need to have all the answers or be certain something went wrong.

Speaking to a specialist is about having someone experienced look at things with you and sense-check what’s happened.

If there are concerns, we can explain what would normally be expected and help you understand whether your child’s care followed that. From there, we’ll talk through your options with you, so you can make the decision that feels right for you and your child.

Speak to our experienced surgical negligence team

If your child’s cleft treatment involved delays, unexpected changes, or decisions you didn’t fully understand, you are not alone.

Our specialist lawyers are supporting families to help them understand what happened, access the right support, and, where appropriate, pursue compensation to protect their child’s health and future.