Research Coordination and Technical Support Unit, Instituto de Mayores y Servicios Sociales (IMSERSO)
The Spanish national action plan to guarantee access to high-quality and affordable long-term care and implement the European Care Strategy.
On 8 December 2022, the European Commission made a proposal for a Council recommendation to support Member States in their efforts to improve access to affordable high-quality long-term care. This proposal is a key action under the Commission’s European care strategy, of September 2022, and supports the implementation of the European Pillar of Social Rights, adopted on 4 March 2021.
The European Care Strategy provides guidelines on the direction of reforms to address the shared challenges of affordability, availability, quality, and the care workforce, and on sound policy governance in long-term care.
Adequacy, availability and quality
The first group of recommendations stands for adequacy, availability and quality of long-term care. In this regard, the Council calls on Member States to improve the adequacy of social protection for long-term care, in particular by ensuring that long-term care is timely, comprehensive and affordable.
The offer of long-term care services must also be increased, in order to cater for different needs and to support the freedom of choice of people in need of care. This means developing and improving home care and community-based care, closing territorial gaps to guarantee access to long-term services in rural and depopulating areas, incorporating technology and digital solutions for independent living, ensuring accessibility to services and facilities to persons with specific needs and disabilities, and offering integrated care based on a good coordination with sanitary care systems.
Finally, Member States must commit themselves to the quality of long-term care by establishing a quality framework, enforcing compliance with quality criteria across all long-term care settings and providers of different legal status and from national, regional and local levels, and also by providing them sufficient resources and incentives towards the improvement of quality continuously and the promotion of independent living and inclusion in the community in all long-term care settings.
Carers
The second group of recommendations addresses carers’ needs. First, fair working conditions should be ensured, which implies the development of attractive wages in the sector and the promotion of highest standards in occupational health and safety for all long-term workers. The challenges of vulnerable groups of workers, such as domestic long-term care workers, live-in carers and migrant care workers, should also be faced up. In addition, skills needs and worker shortages in long-term care are issues of concern to be tackled. Different measures are proposed to be implemented by Member States.
This proposal does not neglect the needs of informal carers and urges Member States to establish clear procedures to identify informal carers and support them in their caregiving activities.
Governance
Finally, the aim of the last group of recommendations is to ensure sound policy governance and a coordination mechanism to design and deploy actions and investments in long-term care.
Imserso has been appointed as the Spanish long-term care coordinator and has overseen the design of a national action plan, which was submitted to the Commission in June 2024. This national action plan includes the whole set of measures, at the national, regional and local level, that respond to the Council Recommendations.
All relevant stakeholders at different administration levels, have been involved in the drafting of this national action plan and have contributed with their proposals for measures.
Synergies with the National Strategy for a new model of care in the community: a deinstitutionalization process 2024-2030.
Spain’s response to the EU Council’s recommendation has converged with work that was already underway towards a profound and wide-ranging change in the care model, and which is reflected in the National Strategy for a new model of care in the community: a deinstitutionalization process, which was presented by the Spanish Ministry of Social Rights, Consumer Affairs and 2030 Agenda on June 13, 2024.
This strategy constitutes a decisive commitment on the part of the Spanish State to the transition towards community-based models, with a rights-based approach, which offer personalised care and place the person receiving care at the centre of any intervention, promoting social connections and enabling people to stay within their communities, irrespective of their care and support needs.
The temporal and purposeful confluence between this strategy and Spain’s response to the EU Council’s recommendation has fostered collaborative and coherent work between both planning processes. Moreover, the analytical and highly participatory process generated to design Spain’s care policy has allowed the action plan submitted to the Commission to offer an ambitious and comprehensive approach that includes a significant number of measures responding to all of the recommendations.
In conclusion, Spain’s response to the EU Council’s recommendation faces up the main challenges of our long-term care system and provides a committed response to all the Council’s recommendations, aimed to ensuring the access to high-quality and affordable long-term care. The final purpose of this action plan is to guarantee the dignity and well-being of care recipients, as well as their family and professional carers.
Together with the National Strategy for a new model of care in the community: a deinstitutionalization process, the Spanish implementation of the EU Council’s recommendations represents a historic opportunity to transform Spain’s care system and, therefore, to improve people’s quality of life.
To find out more about this Spanish action plan and the EU Council’s recommendation:
Estrategia Europea de Cuidados – Instituto de Mayores y Servicios Sociales
Suggested citation:
Instituto de Mayores y Servicios Sociales (IMSERSO) (2025, 23 January). European care strategy implementation. Spain’s response to the EU Council’s recommendation of 8 December 2022 on access to high-quality and affordable long-term care (Technical author: Espantaleón, L.). GOLTC Blog, Global Observatory of Long-Term Care, Care Policy and Evaluation Centre, London School of Economics and Political Science.