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according to how they think they relate to one another, and then rate each statement’s importance (with
respect to the focus prompt) relative to all other statements. Sorted data are then analysed quantitatively
(using multidimensional scaling) to map out relationships among individual statements, and cluster
analysis is used to identify clusters of statements representing common aspects of the studied area. Finally,
the map and its clusters are interpreted qualitatively together with rating data as a means to aid their use in,
e.g., evaluation, planning and development. GCM has been used in a large variety of settings and purposes,
including educational ones. For example, we have found GCM to be a valuable and very appropriate
[28]
approach for evaluating and planning educational activities in higher education and for assessing the
[29]
value of educational interventions for healthcare professionals .

For ECCE, the first phase of the GCM involved the generation of statements and short sentences in
relation to this question: “An important thing to help improve equality of care is…” These statements and
short sentences were generated by healthcare professionals and members of the ECCE Action attending
the ECCE meeting in Kristianstad, Sweden, on 14 December 2019. The second phase, which involves the
conceptual sorting and importance rating of the statements generated in the first phase, is ongoing.

In the final year of the Action, a comprehensive plan for a minimum standard of multidisciplinary cleft and
craniofacial care will be developed based on the outcomes from the areas mentioned above as well as the
COST Action members’ feedback. The creation of this standard will take into account the following aspects
of health system goals.
1. Health: Improving the health condition for all individuals affected by cleft and craniofacial conditions
2. Responsiveness: In this context, all affected individuals and their families should have the same right
to comprehensive treatment in Europe; hence, it is paramount to include differences concerning
economic, social, demographic and other factors
3. Fair financing: All affected individuals should have access to comprehensive care and should not
become impoverished or pay a disproportionate share of their income in obtaining needed healthcare
or forfeit it because they cannot afford it

The envisioned benefits from scientific and socioeconomic perspectives are:
Scientific perspective
1. The ECCE Action will establish a sustainable network of European scientists and clinicians dedicated
to research on how to provide and deliver the best care for families affected by cleft and craniofacial
conditions.
2. The ECCE Action will agree on study designs in the different specialities for cleft and craniofacial
research. This will enable studies to be undertaken with comparable models and comparable assessment
tools.
3. The ECCE Action will facilitate enhanced research in this area across Europe, especially in those
countries that have low healthcare expenditure. This has the potential to improve the provision of care
for the families affected by cleft and craniofacial conditions.
4. The ECCE Action will increase the knowledge and skills of researchers and clinicians through their
participation in the Action’s activities.
5. The ECCE Action will enable a direct comparison of cleft and craniofacial care in Europe via the
participants involved in the Action.

Socioeconomic perspective
1. The ECCE Action will facilitate the exchange and dissemination of knowledge on the effects of having
an adequate provision of care for families with cleft and craniofacial conditions. This will help clinicians
in each of the multidisciplinary team mentioned specialities to implement appropriate care, informed
by evidence-based practice.