Looking after people with LTC needs is often complex and can involve, in addition to unpaid carers, a large number of agencies and professionals. The effective coordination of this activity is key to improving the efficiency of the care system and to providing truly personalised support.

Across EU countries, system reforms are being implemented to increase the degree of “integration” of care. These new models include new payment structures, the use of performance-related incentives, and different structures for commissioning and providing services. It is believed the incentives introduced as a result will lead to better coordination of the different elements of the health and social care system, and ultimately to improving the wellbeing of patients and their families, the efficiency of the agencies involved in the delivery of care, and to reducing system costs.

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However, the available evidence about how these systems work and about their impact on costs and outcomes is limited and fragmented. As a result, it remains unclear how to design optimal incentive mechanisms to improve coordination of care.