With the ongoing ageing of the European population, the demand for health and long-term care is projected to increase significantly, posing challenges for the adequacy and sustainability of health and care systems.
Proactive policies focusing on the availability of long-term care services are essential to address the projected increase in demand. The Laurel project (funded by EU HORIZON) aims to create actionable policies and training tools to support high-quality integrated long-term care (I-LTC) across Europe. Laurel commenced its work on February 1st, 2024 and will continue until January 31st, 2027.
An early step in the Laurel project is the development of FLINT: the European framework for long-term integrated care. This framework helps to characterize I-LTC programmes by showing how various aspects—such as human, social, and organizational factors—are related. This should make it easier to understand the impact of an I-LTC programme. Below is a brief explanation of how FLINT was developed and what it entails.
Development of the framework
FLINT is based on existing frameworks for I-LTC. Its development involved two steps:
- A literature review: Frameworks were selected if they were relevant to integrated care (IC), long-term care (LTC), or a combination of both (I-LTC). Frameworks focusing only on specific diseases, life stages, or target groups were excluded. Out of the 69 identified frameworks, 15 frameworks were deemed suitable. Based on these frameworks, six domains and related items were deduced.
- Validation through a survey and focus groups: the survey aimed to check whether the domains and items were found relevant and to identify any missing aspects. The focus groups aimed to gather feedback on the framework’s clarity and practical usability. Participants in both included experts in the field of IC, LTC, or I-LTC from healthcare and academia, including researchers, healthcare professionals, policymakers, and programme managers. Their expertise was essential to ensure the framework’s accuracy and applicability.
Based on the feedback from experts, the framework was refined and expanded (see the Figure). The domains and items were clarified, and detailed descriptions were added for each item to clarify them. Items were categorized into three levels:
micro level focuses on individual care and interactions between people in need for care, the informal care workforce, and/or the health or social care professionals;
meso level covers interactions within organizations and communities;
macro level addressed broader system-wide aspects, such as policymaking and regulations.
Besides, FLINT emphasizes the necessary contribution of the unpaid care workforce. These are shown in the figure by an asterisk:
*applies to both the paid and unpaid care workforce
Next steps
The goal of FLINT is to comprehensively capture the complexity of I-LTC and improve its implementation in practice. As a next step of the Laurel project, FLINT will be applied to real-world practices to identify what works well and where further improvements are needed. In this phase, feedback from individuals receiving care will also be incorporated. This way, FLINT becomes a practical tool for defining proactive policies and delivering integrated, person-centred care.
More information
A scientific paper on the FLINT framework is in preparation and will be shared on this page and via LinkedIn once it is published.
The Panaxea team has led the development process of FLINT and collaborated with Fundació de Recerca Clínic Barcelona-Institut d’Investigacions Biomèdiques August Pi i Sunyer (FRCB-IDIBAPS) (project coordinator), International Foundation for Integrated Care (IFIC), AGE Platform Europe, Eurocarers, European Health Telematics Association (EHTEL), European Social Network (ESN), Social Economy Europe (SEE), and Universidad Politécnica de Madrid (UPM).
For questions about the Laurel project, please visit the Laurel website or sign up for the newsletter.