WHO/Europe launches a new toolkit to help countries to transform long-term care systems

In a major step towards enhancing the quality and accessibility of long-term care (LTC) across Europe, the WHO Regional Office for Europe has launched its new State of Long-term Care Toolkit. This practical, innovative resource aims to support policy-makers at regional, national and local level in reshaping LTC systems to be more responsive, inclusive and sustainable.

Every country in Europe is experiencing population ageing, and with ageing and increased prevalence of chronic conditions come increased needs for LTC. LTC includes support and services that help people at ongoing or high risk of losing physical or mental capacity to maintain a level of independence and quality of life that respects their basic rights, freedoms, and dignity.

Developed with financial support from the European Commission's Directorate-General for Employment, Social Affairs and Inclusion, the toolkit is part of the European Care Strategy and advances the Council Recommendation on access to affordable high-quality long-term care. Unveiled in Brussels on 12 November at an all-day event on the need to ensure affordable access to quality LTC, the WHO toolkit introduces a comprehensive framework that places people and their unique care needs at the centre of LTC reforms.

"This toolkit is a game-changer. It offers countries a pathway to building LTC systems that truly serve people by prioritizing their care needs, preferences and expectations," said Dr Natasha Azzopardi-Muscat, Director of Country Health Policies and Systems at WHO/Europe, at the launch event. "It supports an inclusive approach, urging leaders to work with families and communities to shape policies and services that reflect our shared commitment to dignity, respect and quality in care. We encourage all policy-makers to take up this toolkit, implement it, and champion a future where no one is left without the care they need."

Conceptual framework to promote progress in LTC

The toolkit is designed to promote collaboration, trust and shared learning among stakeholders, underscoring an evidence-based approach to understanding and addressing the complex dynamics of LTC systems.

To achieve this, the toolkit has 3 main components: a conceptual framework that defines the broader components of LTC systems and mechanisms for LTC reform and includes a glossary of terms; an implementation guide; and a detailed data-collection template. Together, these elements form a structured process for tracking progress, identifying priorities for improvement, and fostering consensus and trust among diverse stakeholders.

The toolkit proposes a holistic approach to LTC system development, underpinned by a "results chain" structure. This approach brings together 5 key components: population care needs, system inputs, system outputs, system outcomes, and population-level impacts.

This model urges policy-makers to consider the resources available within the LTC system, both tangible (such as infrastructure and workforce) and intangible (such as funding mechanisms), and to evaluate how effectively these resources are being used to deliver care services and meet the goals formulated in national policies.

"In the face of multiple competing challenges, LTC systems in the European Region must learn rapidly and adapt constantly," explains Dr Stefania Ilinca, lead author and Technical Officer for LTC at WHO/Europe. "By prioritizing dialogue, deliberation and co-development, the toolkit provides a blueprint for inclusive development of evidence and knowledge, but also for building trust and consensus between people with care needs and their families, care professionals and care providers, civil society, policy-makers, and other key stakeholders in LTC."

The toolkit is also designed to be adaptable, enabling countries to use it as a foundation for creating a national monitoring system for LTC or as a resource to guide decision-making on specific issues, such as workforce development or community-based services. This flexibility makes it a valuable tool for countries at different stages of LTC development.

Supporting transformation in LTC

As WHO/Europe continues its commitment to promoting accessible, high-quality LTC, the launch of the toolkit marks an important milestone.

"We hope that all countries will leverage this toolkit to rethink and transform their LTC systems," Dr Ilinca added. "By putting people at the centre of care, engaging all stakeholders, and investing in robust, data-driven policies, we can create a future where quality, affordable LTC is a reality for all."

WHO/Europe has also launched 3 separate country-specific studies for Greece, Ireland and Lithuania, which identify key challenges and priorities for progress in transforming their LTC systems in line with national goals.