The European Commission is supporting Member States to implement the Council Recommendation on access to affordable high-quality long-term care through a series of thematic Mutual Learning workshops.

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The workshop provided participants with an opportunity to exchange among themselves and with experts on challenges and best practices related to ensuring adequacy of social protection for long-term care, with particular attention to aspects related to timeliness, comprehensiveness and affordability.

Main takeaways

Advancing integrated care

Horizontal and vertical fragmentation constitute an obstacle for achieving comprehensiveness in terms of service provision.

Long-term care services are often fragmented across different governance levels, across different professions and providers, and also concerning data collection. Tools and procedures need to be able to bring staff from different professions together to provide comprehensive and person-centred care, and to balance the need for standardisation with the flexibility to adapt the care to the needs of the individual.

Ensuring comprehensiveness through needs assessment

The development of needs assessment processes demonstrates a trend to include more than functional limitations in activities of daily living, namely also cognitive decline and limitations, as well as social participation.

Moreover, comprehensiveness can be increased by also strengthening the role of prevention of future care needs in the needs assessment process.

Improving timeliness through legislation, outreach services and monitoring activities

Timeliness of needs assessment can be ensured through maximum waiting times enshrined in law and penalties for delays. It is important to also have procedures for urgent service provision besides the standard procedure.

However, timeliness also depends heavily on the availability of trained staff to provide timely comprehensive care. Outreach services, facilitating ageing in place, raising awareness about services and monitoring are additional options for improving timeliness of service provision. 

Addressing affordability

The affordability of long-term care can be ensured by providing a sufficient level of cash or in-kind benefits to cover a comprehensive set of needs.

While means-testing is a key strategy for targeting those most in need, this can lead to substantial unmet needs. Recent trends also include reforms to reduce private expenditure on residential care. 

Background

The Recommendation invites Member States to ensure the adequacy of social protection for long-term care, in particular by ensuring that all people with long-term care needs have access to long-term care that is:

• timely, allowing people in need of long-term care to receive the necessary care as soon as, and for as long as, needed;
   
• comprehensive, covering all long-term care needs, arising from mental and/or physical decline in functional ability identified through an assessment based on clear and objective eligibility criteria, and in coordination with other support and welfare services;
   
• affordable, enabling people in need of long-term care to maintain a decent standard of living and protecting them from poverty and social exclusion due to their long-term care needs as well as ensuring their dignity.