The CRANE Newsletter Issue 2023 (2) is now available to download.

This issue includes information on:

• Outcomes and birth years to be included in the 2023 Annual Report;
• cleft teams in Scotland joining the CRANE Database;
• our upcoming Quality Improvement (QI) webinars on 15 and 23 May 2023; and
• other key dates and deadlines for 2023.

The Newsletter has been emailed to all our known contacts at services that provide cleft care in England, Wales, Scotland and Northern Ireland. If you would like to be added to our eNewsletter mailing list, please contact us.

We are delighted to announce that, as of 1 January 2023, cleft services across Scotland have joined teams in England, Wales and Northern Ireland in recording their data in the CRANE Database. This means that, for the first time, CRANE is a pan-UK audit, which in future will allow for benchmarking of services across all four nations in support of our shared quality improvement goals.

Scottish teams will be entering data prospectively from 1 January 2023. As such, it will take a few years until there is sufficient data from Scotland on the CRANE Database to enable meaningful comparison with other UK cleft services. However, discussions are ongoing about the feasibility of commencing retrospective data entry, if consent can be obtained for relevant patients. We will keep all stakeholders updated as discussions progress.

Craig Russell, CRANE Clinical Project Lead, commented: ‘This is an exciting development for CRANE that will undoubtedly help improve the care we offer to cleft patients across the whole UK. All of us at CRANE look forward to working with Scottish cleft services and other stakeholders to ensure we make the most of all of the opportunities offered by being part of a pan-UK audit.’

At the Cleft Care Scotland Annual Education Event in November 2022, representatives of the CRANE team had an opportunity to (1) meet members of Scottish cleft services in advance of Scotland joining CRANE in 2023, and (2) give an overview of CRANE resources and outputs that will be of particular value to the cleft service in Scotland. Read more about this here.

We are pleased to announce that from this year’s CRANE annual report, we will be returning to the pre-pandemic practice of reporting on 5-year outcomes of births from 3 grouped years.

This means that the 2023 CRANE report will analyse 5-year outcomes for births in 2014–16.

Due to the impact of the pandemic on some units’ capacity for audit activity, the CRANE annual reports in 2020–22 deviated from this pattern.

• Rather than reporting on births in 2010–13 as planned, the 2020 annual report looked back at 10 years of data;
• In 2021 we reported on 2011–13 births plus a summary of 2014 births (rather than reporting on 2012–14 births in full); while
• In 2022 we reported on 2012–14 births plus a summary of 2015 births (rather than reporting on 2012–15 births in full).

Following consultation with the Chair of the Cleft Development Group (CDG), we have agreed it is appropriate to address the time-lag in reporting for 2023. This will be mirrored in the reporting of registrations, which for the 2023 reports will be for the period 2020–22.

Cleft units should therefore be prepared to provide data on the following in 2023, in line with the data collection milestones for 2023:

• 5-year outcomes for births in 2014–16; and
• Registrations of births in 2020–22.

The first deadline for data submissions is 3 April 2023, when an extract will be taken to inform the preliminary report.

More information about data items collected by CRANE can be found in the Data Dictionary and in the information about the indicators submitted for the quarterly Specialised Services Quality (SSQ) Dashboard.

Please contact us with any queries about the eligible birth years for the 2023 report.

The CRANE Newsletter Issue 2023 (1) is now available to download.

This issue includes information on:

• publication of the 2022 Annual Report, 2022 Patients’ and Parents’/Carers’ report and infographic;
• how to create a local action plan based on the report’s recommendations, to drive quality improvement for your cleft team;
• our January 2023 ‘Making it Better’ event, which will be an opportunity to reflect on the findings of the forthcoming 2022 Annual Report; and
• key dates and deadlines for 2023.

The Newsletter has been emailed to all our known contacts at services that provide cleft care in England, Wales and Northern Ireland. If you would like to be added to our eNewsletter mailing list, please contact us.

Following the successful pilot of the CRANE Outlier Policy in 2021, plans for the gradual roll-out of the outlier process have now been agreed with the Cleft Development Group (CDG).

The Outlier Policy is designed to assess and manage the performance of cleft services against agreed process and outcome metrics, and sets out the process the CRANE Database Team will follow to manage any service that is found to fall outside the expected range of performance.

The policy will be instituted in a passive form for the first 3 years (2022-23 inclusive), which means services will be notified of their status and allowed to respond but will not be mandated to do so. This approach takes account of the ongoing pressures on services as a result of the COVID-19 pandemic, and will also allow time for the local outlier processes and policies introduced in 2021 to become embedded within routine practice.

It is planned for the Outlier Policy to be implemented in full from 2025.

If you have any questions about the CRANE Outlier Policy, please contact us.

The Cleft Registry and Audit NEtwork (CRANE) Database has published its 2022 Annual Report.

This report presents results from the prospective audit of children born with cleft lip and/or cleft palate between 2000 and 2021, in England, Wales and Northern Ireland.

You can also download an infographic of the key findings here, and a summary report for patients and parents/carers here.

The Cleft Registry and Audit NEtwork (CRANE) is a national registry and clinical audit run by the Clinical Effectiveness Unit (CEU) of the Royal College of Surgeons of England (RCS).

If you have any queries about this report or this programme of work, please contact us.

For more information about the CRANE Database, please visit our FAQs for professionals and the public.

The CRANE Newsletter Issue 2022 (4) is now available to download.

This issue includes information on:

• a new user guide explaining what cleft services need to do to comply with the National Data Opt-out in relation to the CRANE audit and registry;
• upcoming data submission deadlines, including data milestones for 2023;
• new infographics highlighting the key findings from our annual reports – ideal for engaging patients and families; and
• a reminder of our January 2023 ‘Making it Better’ event, which will be an opportunity to reflect on the findings of the forthcoming 2022 Annual Report.

The Newsletter has been emailed to all our known contacts at services that provide cleft care in England, Wales and Northern Ireland. If you would like to be added to our eNewsletter mailing list, please contact us.

The CRANE Newsletter Issue 2022 (3) is now available to download.

This issue includes information on:

• new publications and conference activity from CRANE, including the International Congress of Cleft Lip, Palate and Related Craniofacial Anomalies 2022, held in Edinburgh in July 2022;
• the online Quality Improvement (QI)  events in February and May 2022, plus details of our next event in January 2023 – which will focus on the forthcoming 2022 annual report;
• the next SSQ Dashboard data submission deadline; and
• a reminder of all the resources available to support your data entry and verification.

The Newsletter has been emailed to all our known contacts at services that provide cleft care in England, Wales and Northern Ireland. If you would like to be added to our eNewsletter mailing list, please contact us.

The national data opt-out service allows patients to opt-out of their confidential patient information being used for purposes other than their immediate clinical care. All NHS organisations are required to be compliant with the national data opt-out policy.

Guidance on the deadline for compliance and how to comply is provided on the NHS website: https://digital.nhs.uk/services/national-data-opt-out/operational-policy-guidance-document/compliance-with-the-national-data-opt-out

For national clinical audits such as the CRANE, where families consent to the audit function of CRANE, and registry information is collected with Section 251 approval:

1. Cleft services are advised to continue to verify the consent status of patients, to be able to collect both registry and audit (outcomes) information – as detailed in our information leaflets.

• In addition, the withdrawal of patients’ consent can be implemented at any time by changing the patient’s consent status to ‘No’.

2. An important consideration for cleft services is to remember that CRANE also has a registry function.

• Therefore there is a minimum dataset that CRANE is allowed to collect, on all children born with a cleft, under our Section 251 approval. For a reminder of these data items please consult the CRANE Data Dictionary found in the Resources section of this website.
• Nevertheless, if the parent chooses to opt-out of their child’s confidential patient information being used for purposes other than their immediate clinical care, none of the child’s data should be recorded in CRANE – this includes both registry and audit data.

Please see the flow diagram below for a visual representation of the information above.

You can also download our user guide about the National Data Opt-out.

If you would like further information on how cleft services can ensure they are compliant with the national data opt-out, specifically with regard to the CRANE, please do contact us with your questions.

The dental health outcomes data collection section in CRANE has been updated.

• This reflects changes requested by the Dental CEN.
• To allow the collection of Developmental Defects of Enamel (DDE) data.

What does this mean for Dental Health data collection?

• CRANE continues to collect data on decayed, missing or filled teeth (dmft at 5 years and DMFT at 10 years).
• CRANE now also collects DDE data at 5 and 10 years of age.
  • Please view Dental Health Outcomes Data Entry Guide for further information.
• The CRANE Data Dictionary and associated ​​​​CRANE Data Collection Forms have been updated to reflect these changes.

Contact us if you have any questions about this, as well as if you have suggestions to improve the guide.