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InCARE Policy Brief no. 3: Co-developing and contextualising long-term care innovations in Europe using Theory of Change- lessons from InCARE

Ensuring affordable and high-quality care to all those who need it, a goal enshrined in the European Pillar of Social Rights, remains a considerable challenge for all EU Member States and other European countries. In the aftermath of the devastating effects of the COVID-19 pandemic on long-term care systems, considerable reforms are being implemented or planned across the region – including the first European Care Strategy, with sustainability and appropriateness of care recognized as paramount concerns. At the same time, there is growing recognition of the need to deliver care in the community and to reimagine traditional care models through socially innovative approaches, grounded in local community strengths and reflecting their needs and preferences. As momentum for re-imagining long-term care systems continues to build, strategies to empower stakeholders and co-develop contextually relevant and scalable solutions are important to ensure sustainability, relevance, and fit of long-term care innovations. Theory of Change, a planning and evaluation approach which is increasingly used in planning health and long-term care provides a systematic and robust way to approach this.

We have successfully applied Theory of Change in InCARE. Our experience offers a proof of concept for the applicability and usefulness of this approach in long-term care service and policy development. In this Policy Brief, we describe the Theory of Change process in InCARE and focus on formulating transferable lessons and recommendations for expanding Theory of Change approaches in this field.

InCARE Policy Brief no.3

InCARE Policy Brief no. 2: The time to care about care! Responding to changing attitudes, expectations and preferences on long-term care in Europe

Fifteen years after the Special Eurobarometer 283 on Health and long-term care in the European Union, the results of the cross-national InCARE survey bring to light significant changes in the attitudes, expectations and long-term care experiences of Europeans. As momentum for reform is building both at national and European level, we find the policy discourse has not kept up with dynamic preferences and attitudes towards care, especially among younger cohorts.

Overwhelming support for increasing the role of the State in long-term care organization, provision and financing and shifting the burden of care away from families and individuals, is improperly reflected in current policies. This leads to declining trust in care systems, as well as increased the reliance on informal carers at the detriment of their health and wellbeing

Since 2007, the ability of care systems to adequately address evolving care needs has declined: residential care is unaffordable for many, and the supply of community-based services is falling considerably behind a rising demand. Rural communities and poorer individuals bare the brunt of growing capacity gaps, while women are disproportionately affected by the burden of frequent, intensive and undesired informal caregiving spells.

A reorientation towards person-centered, participatory, equitable and accessible care models is urgently needed to rebuild declining public trust in the ability of care systems to respond to the preferences and expectations of individuals and communities.

InCARE Policy Brief no.2 

InCARE Factsheet no.2 : Attitudes, experiences and expectations on long-term care
in Spain/ Actitudes, experiencias y expectativas en los cuidados de larga duración en España

The factsheet provides an accessible summary of the key findings from the data collected by the InCARE survey in Spain and across Europe. Our results indicate:

  • Limited availability and high costs are commonly cited as barriers in access to care in Spain, suggesting a need for increasing financial protection and improved planning of care delivery
  • Spanish respondents have very low trust that the long-term care system will be able to respond to their future care needs, especially regarding the capacity and accessibility of community-based care solutions
  • Attitudes and preferences for care arrangements are shifting away from the traditional familialistic grounding of the Spanish care system, and towards a stronger role of the State and of professional services in long-term care provision

InCARE Factsheet Spain (EN)      

El factsheet ofrece un resumen accesible de las principales hallazgos de los datos recogidos por la encuesta InCARE en España y Europa. Nuestros resultados indican:

  • La limitada disponibilidad y los elevados costes suelen citarse como obstáculos para el acceso a los cuidados en España, lo que sugiere la necesidad de aumentar la protección financiera y mejorar la planificación de la prestación de cuidados
  • Los encuestados españoles tienen muy poca confianza en que el sistema de cuidados de larga duración sea capaz de responder a sus futuras necesidades, especialmente en cuanto a la capacidad y accesibilidad de las modalidades de atención comunitaria
  • Las actitudes y preferencias en cuanto a los cuidados se alejan del tradicional modelo familiar del sistema de cuidados español y se inclinan por un mayor papel del Estado y de los servicios profesionales en la prestación de cuidados de larga duración.

InCARE Factsheet España (ES) 

 

InCARE contribution to call for evidence on European Care Strategy

The InCARE project brings together a multi-disciplinary group of 10 project partners across 6 European countries, representing care service providers, public authorities, research and academic institutions and NGOs. Eighteen months into our joint work, we wish to contribute to the on-going call for evidence a summary of results and learnings derived from a rapid evidence review on social innovation in long-term care, an online survey on attitudes, experiences, expectations on long-term care and multi-stakeholder Theory of Change processes in 3 countries.

We argue that long-term care policy in Europe should focus on:

  • Promoting an inclusive, person-centered, rights-based and value-driven vision for long-term care systems and service development
  • Promoting participatory approaches to decision-making and empower local actors
  • Investing in community-based care solutions
  • Investing in the development of data infrastructure in long-term care
  • Matching investment in design and development of innovative long-term care services with investment in scale-up and sustainability of innovative approaches
  • Agreeing to ambitious targets at EU and national level, develop national long-term care strategies and increase financial support for the development of accessible, affordable and high-quality community-based long-term care services.

InCARE contribution EU Care Strategy (EN)      

InCARE Factsheet no.1 : Attitudes, experiences and expectations on long-term care
in Austria / Erfahrungen, Einstellungen und Erwartungen zur Langzeitpflege
in Österreich

The factsheet provides an accessible summary of the key findings from the data collected by the InCARE survey in Austria and across Europe. Our results indicate:

  • Informal caregiving and a perceived responsibility of families to provide care remain very common, despite strong preferences for an increased role of the state in care provision and financing;
  • Many Austrians (especially middle aged) have low trust that the care system will be able to respond to their preferences for future care, as limited availability and high costs are identified as key barriers in access;
  • Gender, age, socio-economic and rural/urban gaps in expectations, experiences and barriers to care highlight the need to increase social protection and address persistent inequalities.

InCARE Factsheet Austria (EN)      

Das Factsheet bietet eine verständliche Zusammenfassung der wichtigsten Ergebnisse der InCARE-Umfrage in Österreich und ganz Europa. Unsere Ergebnisse zeigen:

  • Informelle Pflege und die Auffassung, dass die Familie für die Pflege verantwortlich ist, sind nach wie vor weit verbreitet, obwohl eine stärkere Rolle des Staates bei der Bereitstellung und Finanzierung der Pflege befürwortet wird;
  • Wenige ÖsterreicherInnen (vor allem im mittleren Alter) vertrauen darauf, dass das System der Langzeitpflege ihre Wünsche und Erwartungen in Bezug auf ihren künftigen Betreuungs- und Pflegebedarf zu erfüllen vermag, wobei mangelnde Verfügbarkeit und hohe Kosten als Haupthindernisse für den Zugang zu Diensten und Einrichtungen genannt werden;
  • Trotz geschlechtsspezifischer, altersbedingter und sozio-ökonomischer Unterschiede sowie einem Stadt-Land-Gefälle bei Erwartungen, Erfahrungen und Zugangshindernissen wird deutlich, dass solidarische Systeme der sozialen Sicherung bei Pflege- und Betreuungsbedarf ausgebaut und anhaltende Ungleichheiten beseitigt werden müssen.

InCARE Factsheet Österreich (DE) 

InCARE Policy Brief no. 1: Promoting Social Innovation in long-term care: A common narrative for change across Europe

In support of policy-makers and organizational stakeholders that wish to engage directly in the implementation of social innovation initiatives in LTC, this Policy Brief summarises  the key lessons arising from a decade of European experiences – with a focus on doing rather than analysing social innovation. We argue that local innovators should shift focus away from ‘best practice’ initiatives and towards defining the ‘best fit for purpose’ initiatives. Furthermore, we highlight the need to match investment in social innovation design and development with investment in scale-up and sustainability of social innovation approaches, in order to increase societal impact.

We propose four key principles that can guide social innovators in long-term care:
Start with the end in mind – shape a common and inclusive vision for progress;
Invent the right solution – redesign the best ideas to best-fit local circumstances;
Bring all aboard – engage meaningfully with as many relevant local stakeholders as possible;
Think big from the very beginning – partner early on with regional and national stakeholders.

InCARE Policy Brief no.1 

InCARE Short Report no.1- Social Innovation in LTC in Europe: Towards a common narrative for change

Long-term care systems throughout Europe are facing the challenge of ensuring affordable and high-quality care to diverse ageing populations, while responding to the societal effects of the Covid-19 pandemic. As sustainability is of paramount concern, interest in socially innovative approaches that build on local community strengths has been steadily rising. In this short report, we step back, take stock and synthesize the key insights that can be derived from the decades long journey of promoting social innovation in Europe, with a view to supporting policy-makers and organizational stakeholders that wish to engage directly in the implementation of social innovation initiatives in long-term care.

InCARE Short Report no.1

Tools

InCARE Research Tool 2: SWOT analysis guide.

This document is intended to be used as part of the situational analysis of the long-term care ecosystems in the three countries participating in the InCARE project (Spain, Austria and North Macedonia), in conjunction with the Situational analysis topic guide (InCARE Research tool 1). The SWOT analysis should begin after the completion of the desk review (see Topic guide) and focuses on the analytical interpretation of the collected information.

InCARE SWOT analysis guide

InCARE Research Tool 1:  Situational analysis topic guide

This document provides the topic guide for carrying out a situational analysis of the long-term care ecosystems in the three countries participating in the InCARE project (Spain, Austria and North Macedonia). The situational analysis provides a comprehensive overview of long-term care system performance, collating data on sustainability, efficiency, accessibility, equity and quality of care for older people with cognitive and functional impairment. It also includes an in-depth analysis of demand for care, grounded in a detailed understanding of the demographic and epidemiological situation in each country.

The topic guide is designed to cover information and dynamics both at national level and at the regional level relevant for pilot implementation.

InCARE Situational analysis topic guide

InCARE Dissemination Plan

This plan is a practical document that describes the dissemination activities undertaken by all InCARE partners to contribute to the achievement of the project’s overall objectives. It sets out in detail the objectives of the communication (why), then discusses the target groups (to whom), the key messages (what) and the tools to be used (how). It explains how Eurocarers is going to disseminate information about the project at European and global levels, while inviting partners to elaborate national-level dissemination plans for each pilot country, providing guidance to that end. The Dissemination Plan also envisages how to monitor the dissemination activities carried out by the partners, in order to assess the implementation of the plan on a constant basis.

InCARE Dissemination Plan V1

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