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On 12 and 13 November, the European Social Network (ESN) held its first entirely virtual annual seminar on how public social services can best contract long-term care (LTC) services and guarantee high quality support for older people with complex needs.

Challenges and Opportunities in Public Procurement of LTC

On day one, participants heard about upcoming challenges and the role of procurement in meeting those.

Making long-term care affordable in an ageing society

Katarina Ivanković-Knežević, Director at DG EMPL, European Commission (EC), along with Diana Eriksonaite, outlined how the EC contributes to the implementation of Article 18 of the European Pillar of Social Rights guaranteeing everyone the right to affordable long-term care services of good quality. José-Luis Fernández, Director of the Care Policy and Evaluation Centre at the London School of Economics in the UK, insisted that financing of LTC should not be a problem: “Every country in Europe can afford it, but it is a political choice to be made. It would not break the economy.”

Attracting and retaining the workforce

Ana Llena-Nozal, Senior Economist and Long-term care Team Leader at the OECD addressed workforce challenges in LTC: “Care workers are facing a significant lower pay than for similar occupations in the hospital sector. We need to increase retention in LTC. This comes with better wages, collective agreements, safety at work, career perspectives and available job training.”

Contracting as ongoing dialogue for improvements

Henk Nies, Director at the Centre of Expertise in Long-Term Care in the Netherlands, shed light on the role of care standards and quality assurance: “LTC contracting is a dialogue about permanent learning and improving, helping providers to adjust their services to constantly become better over time"

Day 2: Ensuring quality in long-term care

On day two, discussions focused on how the quality of long-term care can be improved through contracting, regulation and monitoring.

Shifting the paradigm

An important aspect of the discussions was the shift from quantifiable care quality standards to standards for people’s quality of life. “We see a paradigm shift from quality of care to quality of life, this means placing the user in the centre,” Joseba Zalakain, Director of the SIIS Research Centre in Spain told attendees. By having the person as the focus of care, another paradigm shift seems inevitable - from residential to home and community care. This shift was emphasised by Dr Guido Cuyvers, expert by experience and an active ageing activist from Belgium: “Care must be based on the strength of people. Care providers must allow them to stay at home as long as possible.”

Enabling informal carers and quality community care

Ana Radulescu, Director of Romania’s Social Assistance Training and Evaluation Centre, warned against the risks of community care, if wrongly implemented passing the burden onto informal carers. We need to provide training and support to informal carers. To succeed in the shift, we also have to take their quality of life into account”. Phelim Quinn, CEO of the Health Information and Quality Authority in Ireland emphasised the need for a stronger focus on home and community care settings from a regulator’s perspective: “We need to engage in the regulation of home and community care.”

A double shift

ESN CEO Alfonso Lara Montero concluded that a ‘double shift’ is needed to guarantee access to affordable quality long-term care. A shift from quality of care to quality of life, with the user in the centre, as well as a shift from institutional to community and home care. Public planners, procurers, regulators and financers need to embrace this shift to make our long-term care systems fit for the challenges ahead.

The outcomes of the ESN study and seminar on Procurement and Quality in long-term care will be published in 2021. Keep your eyes on the ESN website and Twitter to get it first.


Resources of the Seminar: