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Following a year of work, the European Social Network (ESN) has published its latest report on long-term care. The report Putting Quality First – Contracting for Long-Term Care examines how public procurement and quality assurance policies can ensure better access to quality long-term care services.

Building on ESN knowledge and members’ expertise

The latest comes a decade after ESN’s 2010 publication ‘Contracting for Quality’. Dr Kai Leichsenring from the European Centre for Social Welfare Policy and Research supported our research, analysing over 70 scientific publications and 30 questionnaire responses from ESN members. Additional input was generated from ESN’s 2020 Seminar on Quality in Ageing and Care.

Using public procurement to ensure care quality

The report confirms that public procurement is generally well established in the area of long-term care across Europe. Many countries use public procurement as a tool to improve and ensure quality of care. For instance, we have seen that social clauses are used in Aviles, Spain to improve the working conditions of staff in home care.

Shifting to community-based long-term care (LTC)

Shifting from residential to home and community care is a trend that will become more and more important in the years ahead. Enabling people to stay in their community will help them experience a good quality of life. It will also help meet the growing demand for LTC - a challenge that is common across European countries.

Successfully linking procurement, quality assurance and community-based services is demonstrated through an example from Swindon in England (UK). By recurring to Mark Friedman’s methodology of outcome-based commissioning, Swindon could significantly reduce admissions to nursing homes and improve the quality of life of people supporting by their local services. This was achieved by establishing a clear link between population outcomes and service performance measures, involving local communities and the voluntary sector to support carers and those in care.

Focusing on a more person-centred approach to quality

In most European countries, legal regulations define quality of LTC services at national or regional levels. An important aspect of quality assurance is the participation of people using services in planning, delivery and evaluation of services. For example, in order to ensure that services are adapted to people’s needs, Hungary has established the possibility of residential self-government for care home residents. This bottom-up initiative helps to ensure that their interests and needs are taken into account in care delivery and the organisation of social activities in residential settings.

Highlighting practice examples and recommendations

The report includes numerous examples of best practice aimed at better-quality outcomes in long-term care. These serve as models for public services across Europe. ESN is committed to providing ongoing recommendations for the EU, national and local levels to prepare long-term care services for future challenges. Our recommendations include:

  1. Support the expansion of home and community care for older people,
  2. Recast the 2010 voluntary Quality Framework for Social Services,
  3. Uphold and implement Principle 18 of the European Pillar of Social Rights (EPSR) underpinning the right of everyone to quality long-term care,
  4. Recognise the importance of informal carers and the care workforce,
  5. Progress towards outcome-based commissioning and procurement of long-term care.

The full report including outcomes and recommendations is accessible here.