EU Council adopts Recommendation on Access to Affordable, High-Quality Long-Term Care

Council of EU logo Central piece of the European Commission’s EU Care Strategy, the Council recommendation on access to affordable high-quality long-term care was adopted on 8 December 2022 by the European Council. While this piece of legislation is not binding (it is not a Directive), it does set out an ambitious framework for progress on the many challenges that long-term care systems face.

Improving access and increasing quality

The Recommendation defines long-term care as a range of services for people who depend on support for daily living activities, in all care settings. It calls for care that is timely, comprehensive and affordable. It recommends to continuously align the offer of long-term care services to the development of care needs, providing a mix of different long-term care services and care settings to cater for different needs, supporting freedom of choice and participation in decision making.

In particular, it calls for:

  • developing home and community-based care,
  • closing territorial gaps,
  • rolling out accessible technology and digital solutions to support autonomy and independent living, and the accessibility of all care services to persons with disabilities,
  • ensuring that care services are coordinated with prevention healthy and active ageing and health services.

The Recommendation furthermore aims to increase and ensure quality in long-term care, setting out a number of quality principles:

  • respect, prevention, person-centredness, comprehensiveness and continuity
  • focus on outcomes, transparency,
  • skilled and competent workforce
  • healthy, safe accessible and environmentally sustainable facilities.

These principles should be incorporated in a national quality framework and enforced in all long-term care settings, with incentives to go beyond minimum quality standards, allocate resources for quality assurance, ensure requirements for quality are integrated into public procurement, promoting autonomy and inclusion and protection against abuse, harassment neglect and violence.

Improving care by supporting the persons who provide care

The recommendation also calls for improving employment quality through social dialogue and effective regulation for vulnerable workers, such as domestic, live-in or migrant care workers.

Care should be further professionalised and developed through the increase of skills levels and professional standards. Informal carers should be supported by facilitating cooperation with professional carers, supporting access to training, counselling, psychological support, respite care and work-life balance measures. In addition, they should be provided with access to social protection and/or financial support.

How can the Recommendation trigger change on the ground?

To implement the recommendation, Member States should:

  • create an effective coordination mechanism and consult all relevant stakeholders at all levels,
  • ensure a national framework for collecting data and gather lessons learned
  • develop a forecasting mechanism for long-term care needs and develop contingency plans for emergencies and unforeseen circumstances.

As the Recommendation does not constitute a piece of ‘hard law’, Member States can implement the Recommendation as they seem fit, but there will be regular exchanges and opportunities to compare with other member States. In the wider EU Care Strategy, the EU’s Social Protection Committee, composed of national experts, is working on common indicators for long-term care, that could be used to compare Member States and monitor progress.

The EU has pointed to already available funds that can be used to implement reforms in long-term care, including the Recovery and Resilience Fund which has a budget line for ‘resilient health and care systems’, the European Social Fund, but also the Cohesion Fund, European Social Fund, Fund for Regional Development, Rural Development Fund and others.

Finally, the Commission will assess progress as part of the European Semester, an annual cycle of review of coordination of social, economic and fiscal policies.

The guidelines on stakeholder participation in the Council recommendation apply to all these processes as well; however, at other occasions such declarations of intent have remained mainly on paper in the past. AGE will therefore work with its members to ensure that the voice of older persons is consulted and heard in the actions of drawing up national actions deriving from the recommendation.

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