Promising policy practices in PC-IC in LTC Person-Centred Integrated Long-Term Care for older adults in Europe

Background: The demographic shift towards ageing populations across Europe has intensified the demand for person-centred, integrated long-term care (PC-I-LTC) for older adults with complex needs. Multimorbidity, frailty, and cognitive impairment contribute to care complexity, increasing the need for coordination between health and social services.

 

PC-I-LTC initiatives have been developing in recent years across Europe and now constitute a diverse landscape of ecosystems that aim to implement common care principles within the specific constraints and affordances. To support improvements in PC-I-LTC, it is thus timely to inquire how do current initiatives perform on key dimensions of PC-I-LTC implementation, what promising policies and best practices can be transferred to new settings, and what areas can be identified as targets for improvement efforts?

 

Within the European project BUILD, we are conducting a systematic mapping and evaluation of promising practices to support policymakers to enhance the quality of PC-I-LTC solutions, and their related governance and policies.

 

Approach: We developed the BUILD self-assessment tool based on the SCIROCCO framework to evaluate PC-I-LTC initiatives. Informed by a comprehensive literature review of existing frameworks and evaluation tools, the tool assesses ecosystem performance The tool evaluates ecosystem performance across 13 key dimensions: readiness to change; structure and governance; information, eHealth and digital infrastructure; process coordination; funding; population approach; person-centred care; evaluation methods; level of integration; innovation management; capacity building; workforce, and inequalities.

 

We are currently engaging PC-I-LTC initiatives across Europe in self-assessment processes through a case studies lens, conducting online surveys and focus groups (online or in-person). We encourage the participation of different stakeholders to capture multiple perspectives at different ecosystem levels. Participants are invited to reflect on their experiences within the PC-I-LTC initiative and discuss their views to reach a shared understanding.

This process helps initiatives to identify policy elements that are functioning effectively and to inform future improvements in PC-I-LTC.

 

Results: To date, more than 50 PC-I-LTC initiatives have been identified across 20 European countries. Two ecosystems have already participated in the BUILD self-assessment process, and several others have confirmed participation.

Preliminary findings highlight several features of PC-I-LTC initiatives that may represent valuable lessons for supporting wider implementation, e.g. the presence of strong governance structures, clearly defined leadership and care pathways, well-established roles for both formal and informal caregivers, secured and sustainable funding mechanisms, and robust political support. In addition, the use of digital enablers and the intentional integration of equity and diversity considerations have emerged as key success factors. Case studies and common findings across the PC-I-LTC initiatives participating in the BUILD assessment will be presented and discussed.

 

Implications: Our findings will contribute to a deeper understanding of how PC-I-LTC can be sustainably implemented across Europe, offering valuable insights to inform policy development, practice, and the design of future interventions. The BUILD self-assessment tool serves as a powerful resource for stakeholders to evaluate how their care ecosystem performs across 13 key dimensions, identify strengths and areas for improvement, and guide future advancements in person-centred integrated long-term care.