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ESN Working Group on Ageing and Care

The second meeting of the ESN Working Group on Ageing and Care took place in Brighton at the end of February. Over the course of two days, senior professionals in local and regional government from eight countries (the Czech Republic, Belgium, Spain, Finland, the United Kingdom, France, Sweden and the Netherlands) discussed European and national policies and practices that address health and social services integration.

The aim of the working group is to increase the capacity of public authorities to plan and manage older people’s services in a sustainable and person-centred manner, and to promote active and healthy ageing. Over the course of five meetings between 2014 and 2016, the working group is looking at the following thematic areas: integrated services, active ageing, workforce and home-based care.

European initiatives for integrated care

At European level, the report Adequate social protection for long-term care needs in an ageing society argues for the need to overcome the fragmentation between the health and social sectors. The European Innovation Partnership on Active & Healthy Ageing (EIP AHA), which brings many EU-funded projects into a single framework for mutual learning, also deals with integrated care.

Toni Dedeu, Member of the EIP AHA Integrated Care Action, pointed out that the aim of the initiative is to collect practices on integrated care from different European countries with the intention to scale-up positive practices. As most of the initiatives come from the health sector, participants at the meeting argued for a social focus on international initiatives on integrated services.

National and regional frameworks for integrated care

Members of the ESN Working Group on Ageing and Care also discussed different national/regional policy frameworks that may support or hinder cooperation between social and health care at local level.

For example, in Finland and Sweden, local authorities have significant autonomy to organise services, but are also incentivised by national policies to promote services cooperation. In the Czech Republic and Latvia, a lack of legislation on long-term care leaves more responsibility to the older person and his or her family.

However, there were also similarities in the organisation of care: health is often allocated at national and regional levels, while social care is often organised and funded by municipalities.

Local and regional practices on integrated care

An analysis of 22 practice examples (provided by the working group members) on health and social care integration was presented by Jenny Billings from the University of Kent. The different practices were analysed across several dimensions: scale of integration (micro, meso and macro), target group, status, staff and evaluation method.

The draft analysis outlines that the main reasons for starting the initiatives were the need for prevention (at micro level) and the need to improve coordination (at meso and macro levels), while other aims included more effective use of resources and care improvement.

Members reported how professionals might work together, including informal and formal arrangements such as steering committees and joint planning. A number of measurable effects were reported as a result of the practices implementation, such as health improvement, better coordination, job satisfaction, increased learning and better use of resources.

Challenges and solutions for integrated care

Based on the analysis of practices, working group members discussed recommendations for the development of integrated care. These mainly addressed staff training, achieving change and organisational barriers, social care indicators linked to outcomes, and transferability of practices.


  • A report with the policy and practice analysis from this meeting will be published soon and all practices will be made available in our Practice Library

  • ESN members can access all resources in the Members’ Area