The design of cleft lip and palate surgery pathways in Wales

This article describes the decisions made relating to cleft surgery pathway design in a single-surgeon cleft service in the United Kingdom at the start of a cleft surgeon's consultant career. Pathways are described according to cleft phenotype and detail aspects of surgical technique, sequence and timing. Transparency is vital to ensure clinical governance and external analysis, especially in the setting of a single-surgeon service. This early declaration of surgical intent aims to lead the way for ongoing reflection, so that future changes to practice can be identified and outcomes monitored.