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Page 8 of 10 Sharratt et al. Plast Aesthet Res 2020;7:35 I http://dx.doi.org/10.20517/2347-9264.2020.99

Whilst the activities of the ECCE Action are ongoing, it has already enabled over 135 researchers and
clinicians from 30 countries to attend one or more of the events facilitated by the Action, including training
schools, short-term scientific missions and conferences, all related to the topic of equality in care. It is
believed by the authors that this exposure to the experiences and healthcare cultures of such a diverse
group of researchers and clinicians can only serve to increase awareness of this topic amongst those
researchers, clinicians and trainees involved in the Action. In addition to facilitating individual awareness
and, potentially, enabling those working clinically to carry this awareness into their practice, those
involved in the Action are committed to sharing their learning with colleagues and, gradually, instigating
organisational change at a local level in order to combat healthcare inequalities where possible.

The activities of the working groups, including the surveys and questionnaires and GCM exercises being
undertaken, the STSMs and the long-term collaborations forged in performing this activity together as
well as during conferences and training schools, will also lead to contributions to the literature on this
topic. This collaboration between participants in the ECCE Action has resulted in four ongoing research
or pilot endeavours concerning the access to and provision of care in cleft and craniofacial conditions and
has generated six further EU grants comprising a total of 16 different country partners and a combined
grant sum of 1,372,000 Euros. In turn, it is hoped that the immediate outputs of the ECCE Action as well
as those stemming from partnerships it has helped create will increase awareness and encourage reflection,
action and application within the clinical, research and healthcare policy spheres. These outputs will also
be important in establishing equality of access to cleft and craniofacial care as a critical issue going forward
and maintaining a focus on the importance of equality of care.

These achievements should be understood against the background of it being a significant challenge
to attract funding to enhance knowledge of relatively rare medical conditions such as cleft and other
craniofacial anomalies. In this respect, COST provides networking opportunities for researchers and
innovators to strengthen Europe’s capacity to address scientific, technological and societal challenges. The
principal areas of activity are promoting and spreading excellence, fostering interdisciplinary research for
breakthrough science and empowering and retaining young researchers and innovators. COST implements
its mission by funding bottom-up, excellence-driven, open and inclusive networks in all areas of science
and technology. Whilst COST does not fund research time, it provides support for networking activities
carried out within Actions and, as has materialised with the ECCE Action, increases the possibility of the
topic under consideration being the subject of further applications for research funding.

The fact that COST puts significant emphasis on helping early career researchers and clinicians grow
professionally is both unique and very important for topics such as equality of care. This is because there
exists an opportunity to influence and shape future approaches to cleft and craniofacial care and research
in Europe. For these groups, the training schools and short-term scientific missions have been, and will
continue to be, powerful tools that can act as an introduction to cross-border collaboration and highlight
future possibilities. Furthermore, COST also prioritises clinicians and researchers from less research-
intensive countries. This has been hugely beneficial in bringing together researchers, especially in those parts
of Europe that have hitherto not had the opportunity to exchange knowledge and ideas with counterparts
in other countries due to limited resources. Indeed, funding is not only open to Action members but also a
limited number of colleagues and researchers in countries represented in the Action. Grants to attend the
conferences and training schools and take part in STSMs are usually sufficient to cover most, if not all, of the
costs of travel, accommodation and subsistence, which ensure networking opportunities are genuinely open
to everyone eligible. In this sense, the ECCE Action has been able to encourage and foster opportunities and
equality within its own members and its own activities, a critical requirement given the focus of this Action
upon equality.