2. Policy and Governance
The focus in this theme is on how policy and governance in LTC address links and interfaces both at the organisational and systems levels. ‘Policy’ here consists of implementation directives, while ‘governance’ is concerned with the linkages between government at different administrative levels and other stakeholders involved in decision-making, performance and control. This theme includes examples within policy papers, reform proposals, task force or working group reports for Ministries or governments, legal texts (preambles), statements by interest organisations or other political stakeholders. Programmes, guidelines and strategies are included as well as analyses and results of comparative research in this area.
2.1 Policy
This sub-theme refers to the key messages within policy papers that relate to LTC, such as from national, regional or local policy levels; from the EU level and other international countries. Examples must describe at least one of the following key issues:
- Policy barriers and opportunities in terms of linking social and health care (eg rhetoric as opposed to more achievable opportunities and results, workforce planning)
- Policies addressing continuity and mechanisms to overcome barriers at the interfaces between social and health care
- Policies addressing continuity and mechanisms to overcome barriers at the interfaces between formal and informal care, in particular to set the balance between caring informally and working
- Policies addressing continuity and mechanisms to overcome barriers at the interfaces between prevention/rehabilitation and cure/care
- Policies addressing continuity and mechanisms to overcome barriers at the interfaces between care at home and residential care
- Implementation strategies
- Policies addressing issues of diversity and equal access, i.e. considering differences according to gender, culture and/or social inequalities
2.2 Legal Framework
A legal framework is a set of rules or procedural steps through which judgements can be made in a legal case. It is also an instrument of policy implementation, together with funding and verbal communication. It may also outline the legal actions that will be taken if contractual obligations or agreements are not met. Examples describe what a legal framework for LTC can look like and must include at least one of the following key issues:
- Legislation which explicitly addresses LTC with respect to informal carers
- Legislation which explicitly addresses LTC with respect to interfaces between health and social care
- Legislation which explicitly addresses LTC with respect to workforce planning
- Legislation which explicitly addresses LTC with respect to authorisation, accreditation, quality systems
- Legislation which explicitly addresses LTC with respect to co-ordination or integration of facilities or services
2.3 Governance Mechanisms
A governance mechanism is a specific procedure associated with decision-making, performance or control of formal and informal long-term care providers. Examples must include at least one of the following key issues:
- Institution building to support and emphasize LTC as a specific area of concern (eg quality assurance agencies, insurance system, awareness campaigns)
- Incentives linked to contractual and financial mechanisms
- Incentives to provide LTC by addressing multi-level governance
- A description of steering mechanisms concerning access and eligibility criteria
2.4 Visibility of key topics
Examples in this sub-theme look at how the core areas of prevention and rehabilitation, quality and informal care are represented in policy and governance. Key issues thus include:
- Programmes and initiatives to promote prevention and rehabilitation
- Programmes and initiatives to promote informal care
- Programmes and initiatives to promote quality development
- Programmes and initiatives to promote user empowerment
