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Spain’s new National Strategy for a new model of care in the community: a de-institutionalization process

Spain’s new National Strategy for a new model of care in the community: a de-institutionalization process


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The Spanish congress approved a new National Strategy for a new model of care in the community 2024-2030 on the 18th June 2024. This post by Spain’s Ministry of Social Rights, Consumer Affairs and 2030 Agenda provides a brief overview of the Strategy’s objectives, the scope of the strategy, and the public participation process through which it was developed.


Objectives of the Strategy:

The National Strategy for a new model of care in the community: a deinstitutionalization process 2024-2030, is a commitment to transform the support and care system so that all people, especially those who have more support and care needs and/or whose situations are more complex, can develop their chosen life projects in their own community, on equal terms with other people and are not forced into institutionalised lives.

This change involves overcoming a deep-rooted social assistance culture and moving towards models of care and support focused on respecting and guaranteeing the rights and dignity of people. This new model of care in the community implies two fundamental shifts:

A people-centered approach

“…where care and support are based on people’s will and preferences”

A community approach

 “…where people can choose where, how and with whom to live, on equal terms with other people, without being forced to live a regimented life”

The Strategy aims to promote personalised service planning and models of support and care, which adapt to the needs and preferences of each person and their different circumstances or parts of their life cycle, transforming infrastructures, promoting a change in the culture of care and developing services within the local community context.

The Strategy also aims to improve the living conditions of the people who provide care to others, supporting care professionals to facilitate the transition towards community-oriented, personalised care and support that supports people’s autonomy and self-determination, as well as supporting families, especially female caregivers and foster families, so that providing care does not become an impediment to their own life projects.


For whom is this Strategy?

This Strategy is fundamentally aimed at people with support and care needs, especially people with disabilities, older people in a situation of dependency, children and youth in the protection system, young care leavers and people in a situation of homelessness. It is also designed to support the families of these people, as well as workers in the care and support sector and people who provide unpaid care. It also targets other population groups who need support in their daily life or are experiencing challenging situations and that are currently institutionalised, such as people with mental health problems, women who have experienced gender violence, refugees, etc.


What is the current situation?

It has been estimated that 4,421,110 and 6,565,901 people require care and support in Spain, which represents more than 10% of the population. Of these, at least 350,258 receive support in residential care settings. At the same time, family care continues to be the backbone of long-term care in Spain. The main family carers are women: daughters, mothers and partners. For decades and still today, the traditional care model has generated gender inequalities, which limits the autonomy, professional development and quality of life of the women who provide care.


What is the scope of the Strategy?

The strategy is articulated around five axes:

  1. Prevention of institutionalisation dynamics
  2. Public participation and awareness
  3. Transformation of care and support models
  4. Development of services to enable transitions towards a life in the community
  5. Enabling conditions for de-institutionalisation

These axes could be summarized in two lines of action and three necessary conditions:

1. The expansion and transformation of the portfolio of services so there are “more and better options for people”, involving:

– A gradual transformation of residential settings towards a home-based model.

– Increase and improvement of the availability of services at home: home help, day services, personal assistance, care managers, care navigators…

– Development of new service models based on housing as an alternative for people who cannot live in their usual home. Housing in the community with supports, collaborative housing, multi-service resources in rural settings and other models.

2. Strengthening and improving the quality of employment.

– Address care workforce shortages

– Facilitate entrance to the care workforce

– Improve and facilitate access to care qualifications for care workers.

– Improvement in salaries and increased personnel ratios.

– New professional roles.

To achieve this will require:

– A new regulatory framework

– Sufficient and sustained financing

– A system to track progress in the implementation of the strategy.


Strategic focus of the implementation plan:

The Strategy’s implementation, monitoring and evaluation plan aims to streamline and coordinate priority actions for the first stage of implementation of the Strategy:

1.     Public awareness of the value of Long-Term Care

2.     Re-orientation of the National system of support for dependency and autonomy (SAAD) towards promoting autonomy and independent living alternatives

3.     Promotion of the “carers plan” to dignify care work

4.     Increased availability of affordable, accessible and stable housing to prevent institutionalisation

5.     Consolidation of the foster family model for children and youth without parental care

6.     Development of a new model of community care in rural areas

7.     Coordination between social and health care to enable integrated person-centred care


How was the strategy developed?

The scope of this strategy required an open public debate. To achieve this, there was an ambitious process of reflection, dialogue, participation and consensus, in which a total of 12,332 people participated (43,800 participations). This process used different participation methods and there were consultations with all the autonomous communities (regional governments), different Ministries, local governments, third sector organizations, experts at national and international level and citizens in general; with a special emphasis in the involvement of experts by experience.


To find out more (in Spanish):

The Strategy’s website:

The Strategy document: :

Videos of Strategy witnesses:

Case studies:

VIDAS social innovation platform:


Suggested citation:

Ministry of Social Rights, Consumer Affairs and 2030 Agenda of Spain (2024, 21 June). Spain’s new National Strategy for a new model of care in the community: a de-institutionalisation process. GOLTC Blog, Global Observatory of Long-Term Care, Care Policy and Evaluation Centre, London School of Economics and Political Science