Deinstitutionalisation is a hot topic nowadays, and there is general agreement that people with long-term care needs should not be forced to live in an institution to have their needs met. What is less clear, however, is how exactly these needs should otherwise be met, especially when the percentage of people with limitations in their day-to-day lives is significant. In 2024, 16.3% of the EU population aged 16-64 had some or a severe level of activity limitation.
As Commissioner for Equality, Hadja Lahbib highlighted in her speech on deinstitutionalisation at the European Parliament in July 2025: “Deinstitutionalisation is not about moving people from one building to another. It is about building lives of meaning and opportunity – at home, in the community, and in society”.
One way of achieving this is through the provision of professional home care and personal assistance schemes, both of which are acknowledged as being crucial elements of person-centred care in the European Commission’s Guidance on independent living for persons with disabilities, a flagship initiative of the Strategy for the rights of persons with disabilities 2021-2030.
The state of long-term care services for adults with disabilities in the EU
Not all EU Member States are advancing community-based services at the same speed, as evidenced by the European Social Services Index (SSI). Launched by the European Social Network (ESN) in 2023, the SSI collects and compares national data on the situation of social services across Europe, including long-term care services for adults with disabilities.
In Croatia, for instance, since 1 July 2023, people with disabilities have the legal right to personal assistance, financed from the state budget. This has resulted in an increase in the number of registered service providers as well as users, with the latter reaching 3,390 people with disabilities aged 18-64 at the end of December 2024, compared to 2,177 project-funded users the previous year.
Nonetheless, despite well-intentioned efforts, home care and other non-residential care services, such as mobile services, continue to be less prevalent than residential care facilities.
In Romania, for example, an ad hoc national strategy defines clear targets in terms of reducing the number of institutionalised adults with disabilities to 10,349 by the end of 2030. However, at the end of 2024, 14,284 adults with disabilities were recorded in residential care facilities across the country, representing over 72% of the adult population with disabilities using services.
The SSI as a tool for the EU to define goals and monitor implementation
The SSI findings for 2024 will cover 16 of the 27 EU Member States and will provide a holistic snapshot of the availability across the region of a variety of social services and their usage among target groups, beyond people with disabilities. Our data will also document services dedicated to older people with long-term care needs, children and young people in care, women experiencing domestic violence, people living in poverty, and homeless people.
The SSI represents an invaluable tool for the European Commission to monitor Member States’ progress in implementing the European Pillar of Social Rights and its related existing initiatives. It can also assist the European Commission in drafting evidence-based recommendations to national governments, including within the framework of the European Semester.
For this purpose, the SSI Working Group’s annual meeting, scheduled to take place in October 2025 in Brussels, the heart of the EU, will involve representatives of the European Commission. They will have the opportunity to reflect on the state of social services and the recommendations put forward by our experts, which will spotlight the elements decision-makers at both European and national levels should address as a matter of highest priority in the coming year.
The national factsheets and a cross-country analysis will be made available on our website in the weeks to follow and, as stated by ESN’s CEO Alfonso Lara Montero during last year’s meeting, they will be key to driving policy change for enhanced access to social services across Europe.
