Learning from long-Term Care practices for the European Care Strategy

Project Information

LeTs-Care

Grant agreement ID: 101132701

DOI

10.3030/101132701

EC signature date 26 October 2023

Start date 1 April 2024

End date 30 September 2027

Funded under

• Culture, creativity and inclusive society

Total cost

€ 2 891 972,19

EU contribution

€ 2 891 971,25

Coordinated by

UNIVERSITA CA' FOSCARI VENEZIA
Italy

Periodic Reporting for period 1 - LeTs-Care (Learning from long-Term Care practices for the European Care Strategy)

Reporting period: 2024-04-01 to 2025-06-30

Summary of the context and overall objectives of the project

Since the 1990s, European societies have tried to balance high-quality Long-Term Care (LTC) for aging populations, employment growth, and cost containment. These efforts are now challenged by the structural features of LTC systems, which often lack institutionalization and are fragmented across government levels and policy areas. After the pandemic, the shortcomings of LTC systems have become a central focus for global and national policy agendas, which support integrated and innovative forms of care. At the same time, the EU's Care Strategy, in line with the European Pillar of Social Rights, promotes a social investment approach to LTC. Within this window of opportunity, there is a need to comprehend the challenges ahead, the patterns and drivers of inequalities in LTC, the potential contribution of emerging practices and the development of contextualised sustainable practices.
LeTs-Care originally combines comparative policy analysis, an ethnographic approach, the study of territorial indicators, fuzzy-set/qualitative comparative analysis and a participatory methodology to contribute a new vision and critical evidence, with three key objectives:
O1: the deep understanding of the diversity of challenges and causes of inequality across contexts as a pre-condition to any effective policy strategy, through knowledge that is new, deep, reflexive and shared.
O2: the deep understanding and contextualized analysis of key “integrative” and “innovative” practices in national and regional/local settings, unveiling their potential for addressing the aforementioned challenges.
O3: the development of a new policy-learning model that enables stakeholders and policy makers to discuss objectives and practices in a more context-specific and reflexive way.
As a result, LeTs-Care will produce not only new knowledge and new methodologies, contributing to understanding LTC challenges and practices in context, but also will support the implementation of the EU Care Strategy by developing the reflexive ability to make sense of the Strategy in context.

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

In its first 15 months, LeTs-Care consortium worked to consolidate the cooperation among partners both online and offline, while initiating the implementation of research-related activities as a core component of the project’s development.
Beyond the fruitful four in-person and two online project meetings, project documents (D1.2 Ethical guidelines; D1.3 Data Management Plan; D5.1 Dissemination, Communication and Exploitation Plan; D5.2 Website and Visual Identity), templates (e.g. interviews and ethnography guidelines, D1.1 Informed consent template) and a collaborative working platform have been agreed to build a common ground to practice systematically comparative and multi-sited research activities, allowing the consortium to start its scientific work.
With reference to O1 (understanding the diversity of challenges and causes of inequality) we collected and analyzed multi-source evidence to disentangle the meanings of taken-for-granted LTC concepts, to identify and discuss the available data for the study of territorial inequalities and to understand the configurations of LTC challenges. A reasoned bibliography (D2.1) a database with policy documents and instruments (D2.2) and 120 interviews with stakeholders (D2.3) were delivered, as well as a comprehensive research report on LTC meanings (D2.4) highlighting how these are both shaped by and contribute to shaping policies and practices.
As a first step towards O2 (comparative analysis and deep understanding of key “integrative” and “innovative” practices) we organized and started to implement 20 ethnographic case studies across seven countries.
Finally, the consortium has organized 15 national workshops with key policy makers and stakeholders to discuss the first research findings. Their active involvement allowed to begin the joint creation of an innovative model for policy learning (O3).

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)

LeTs-Care provides an original and beyond-the-state-of-the-art contribution by reaching these overall results:
1.Production of new evidence on different configurations of LTC challenges in contexts.
While there is consensus that “common challenges” (e.g. care affordability and accessibility; quality of care; quality of care work; and financial sustainability) affect European LTC systems, there is little systematic and comprehensive knowledge of the shapes and meanings of these challenges across national and local contexts. LeTs-Care disentangles the meanings of taken-for-granted LTC concepts that are at the basis of policy agenda by proposing a methodology for the implementation of territorial LTC indicators and by developing a theory-based and empirically informed approach to the analysis of territorial inequalities.
2. Production of an innovative approach to study integrated and innovative LTC practice.
Previous research on LTC practices have often revealed mixed outcomes, difficulties of implementation and strong dependency on the context, posing persistent challenges in terms of transferability, diffusion, expansion/upscaling and sustainability. LeTs-Care will provide a much needed, original methodology to understanding how practices work revealing the tensions – between their objectives, institutional features, and actors -, the choices and trade-offs available to policy makers and stakeholders, and the necessary changes in context needed to make them viable, feasible and sustainable.
3. Provision of a novel approach to policy learning.
LeTs-Care provides a reflexive methodology and toolkit for the contextualised analysis of practices and policies and their development, which spells out to, makes explicit and discusses meanings, interests, objectives, conditions and choices in policies and practices.