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H2020

SPRINT Report Summary

Project ID: 649565
Funded under: H2020-EU.3.6.

Periodic Reporting for period 1 - SPRINT (Social Protection Innovative Investment in Long Term Care)

Reporting period: 2015-06-01 to 2016-05-31

Summary of the context and overall objectives of the project

"Social investment is new wine in old bottles. It tries to resurrect social policy and prevent its marginalisation in a period of austerity by using “appropriate language” (in particular, “investment”). It harkens back to the earlier concept of “social protection as a productive factor”, which, itself, implied investment – social protection yielded a return. It can also be related to “productivist” views of social policy – an approach to which the OECD, at least implicitly, can be said to subscribe. And “social investment” also allows discussion of innovative investing practices into social innovations such as social investment bonds.
Long-term care (LTC) is commonly understood as encompassing the range of services and assistance for people who, as a result of mental and/or physical frailty and/or disability over an extended period of time, depend on help with daily living activities and/or are in need of some permanent nursing care. Despite, or even because of the challenges of the ageing of the population and the need to restore an environment conducive to restoring growth and jobs, it is important not to lose sight of the fact that there is a need to ensure that people’s needs are covered adequately – indeed that the “rights” and the expectations that the European social model implies are satisfied. In a climate of fiscal austerity, it is also important to recognise that attention be paid not merely to the quantity of public expenditure but also its quality. In this respect, it is helpful to acknowledge that what might, at first sight, might be counted as consumption does, in fact, constitute investment. Last, and as the Sarkozy Commission some years ago sought to highlight, the economic performance and social progress can better be understood when not only when those activities that are paid are taken into account but also unpaid and household production (performed particularly by women) is included in any calculation.

The SPRINT research work is an attempt to give meaning to the concept of social investment as applied to long term care provision. The SPRINT project objective is to:
• articulate in more detail the aspirations of the "Social Investment Programme" (SIP) and the Staff Working Document (SWD) on Long-term care in ageing societies
• provide a means for assessing the social costs and benefits of various ways of providing long-term care for the frail elderly, and
• to present examples of approaches that do indeed, facilitate provision in a way that social benefits are achieved."

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

During the first twelve months of the SPRINT project implementation, a tentative effort was done towards the following main actions lines:
i. the SPRINT project identified the current landscape of organisation and resourcing of LTC in Europe in order to understand the place in the discussion that social investment currently has, and how the principles of social investment were n such a way that is welfare enhancing;
ii. It studied in depth the role of all actors in the field of LTC and assess their contribution to the achievement of broader goals, such as active ageing, economic growth and improvement of the status of women both as participants in the labour force and as the principal providers of informal care;
iii. the SPRINT Consortium developed a common vocabulary for social investing and for the financing mechanisms of long-term care, which is based on a holistic approach of the principles of social investment in LTC. For the engagement of the stakeholders in LTC and SI, the SPRINT Consortium created a network of researchers, academics and policy makers to contribute in the Glossary for Social Investment in LTC. In parallel, the SPRINT project involved these experienced scientists, practitioners, experts on LTC and policy makers in the dissemination of the SPRINT project outcomes.
iv. the most appropriate frameworks for the definition and analysis of social impact of LTC programmes were identified and critically assessed by the SPRINT Consortium.
v. the SPRINT project evaluated the fiscal and social costs and benefits of various national approaches at EU countries to LTC delivery.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

"Long-term care constitutes a component of age-determined expenditure included in the analysis of the Ageing Working Group. However, relative to pension costs, which – assuming demographic projections are reliable and current benefit structures are maintained – are relatively easy to assess, long-term care costs are not. There is great uncertainty about morbidity and whether it will be (relatively or otherwise) compressed or extended. There is much less information about who is actually paying for it, simply because it is financed less frequently by single national government agencies and more often by local authorities and local health services. On top of this, there is often a lack of clarity about what constitutes care services, especially when these are paid for on the basis of ability to meet minimum standards of existence and when the boundaries between health- and social-determined need is fluid and often subjective. Social Return on Investment attempts to turn an argument where “soft” social concepts are pitted against “hard” financial metrics into one where, whether or not the parties agree on every item and its “valuation”, at least a common terrain is established. SROI has acquired increasing prominence in some EU countries in recent years. In the UK, there have been efforts to revise the Green Book and associated Magenta Book, which describe how the economic, financial, social and environmental assessments of a policy, programme or project should be combined, have been updated to deal with the valuation of non-market goods. This reflects recognition that there is a role not merely for “traditional” cost-benefit analysis but also for “social” cost-benefit analysis, and that there might be a need to develop methods that take account of subjective wellbeing. The Commission’s own document on Investing in Social Europe provides indications of positive correlations between “social investment budgets” (covering childcare, active labour market policies, education, research and rehabilitation expenditures) and employment rates and, perhaps more pertinent to the current proposal, between prima age female employment rates and the provision of formal child care, as well as quoting OECD findings on the importance of pre-primary schooling on later school outcomes (PISA scores).
The literature reporting on social investment, whilst referring to long-term care is much less extensive in its treatment of it. Equally, whilst long-term care is a subject pertinent to the European Innovation Partnership on Active and Healthy Ageing, the latter has so far touched upon it only tangentially. This means there is genuine scope for a concentrated attempt to develop the social investment concept and to try to apply it to this important area of concern for public policy. SPRINT is innovative in that it seeks to elucidate how long term care can be located within the concept of social investment, will develop a means of assessing the wider social and cost implications of particular approaches to provision and the basis for evaluating proposals for reform and provide an opportunity to test how fit-for-purpose existing SROI procedures are for measuring impact of LTC and allow improvements and refinements to be suggested."

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