LTCcovid Country Profiles

Responses to 4.03. Reforms to develop or improve Long-Term Care data and information systems

The LTCcovid International Living report is a “wiki-style” report addressing 68 questions on characteristics of Long-Term Care (LTC) systems, impacts of COVID-19 on LTC, measures adopted to mitigate these impacts and new reforms countries are adopting to address structural problems in LTC systems and to improved preparedness for future events. It is compiled and updated voluntarily by experts on LTC all over the world. Members of the Social Care COVID-19 Resilience and Recovery project are moderating the entries and editing as needed.

The report can be read by question/topic (below) or by country: COVID-19 and Long-Term Care country profiles.

To cite this report (please note the date in which it was consulted as the contents changes over time):

Comas-Herrera A, Marczak J, Byrd W, Lorenz-Dant K, Pharoah D (eds.) and LTCcovid contributors. LTCcovid International living report on COVID-19 and Long-Term Care. LTCcovid, Care Policy & Evaluation Centre, London School of Economics and Political Science.

Copyright is with the LTCCovid and Care Policy and Evaluation Centre, LSE.

As part of the reforms following the Segur de la sante, 2 billion euros have been invested into digital infrastructure, including 600 million euros for care and nursing homes. These investments will enable the creation of an online health and care portal including a shared health and care records, shared messaging system, records and information relative to hospital discharge, etc. (l’Espace numerique de sante).

Last updated: December 21st, 2021   Contributors: Camille Oung  |  Alis Sopadzhiyan  |  

The care profession bill (Pflegeberufegesetz) led to a revision of the training curriculum and examination procedures. In addition to apprenticeships a degree in care has been introduced. School fees are no longer allowed, and apprentices are entitled to an appropriate compensation. The bill has been fully enacted since January 2020. (Source: Bundesministerium fuer Gesundheit – Pflegeberufegesetz)

In 2019 comprehensive measures were introduced to increase workforce training; improve working conditions and pay; relieve the administrative burden on professional carers; and promote recruitment of care professionals in third countries.  Consequently, up to 13,000 additional posts for qualified long-term care workers were created in nursing homes. The funding of 20,000 additional positions for nursing assistants was secured. Germany also increased salaries in the long-term care sector, The Care Wages Improvement Act in 2019 created a legal basis to improve wage conditions for care workers. As a result, minimum wages for qualified care workers have been introduced and the minimum wages for nursing assistance staff were increased (and previously disparate regional rates were aligned). (source: Publications catalogue – Employment, Social Affairs & Inclusion – European Commission (

In June 2021 a new care reform was passed. From 1 September 2022 care settings will need to pay their care staff according to tariff. (Source: Bundesministerium fuer Gesundheit  – Pflegereform)

In addition, homecare providers and residential care facilities can receive partial funding (up to €12,000 ) through the LTC insurance funds for the purchase of digital and technical innovations to improve the working conditions of staff over the period 2019 to 2021 and reduce time care staff is spending on bureaucratic tasks. (Source: Bundesministerium fuer Gesundheitl; Publications catalogue – Employment, Social Affairs & Inclusion – European Commission (

Another programme makes grants available up to 2024 for measures to improve the work-life balance of professional carers. The country has made efforts to co-operate with third countries to improve vocational training and recruitment of LTC professionals, especially with Mexico, the Philippines, and Kosovo- this will be funded from health insurance funds (source: Publications catalogue – Employment, Social Affairs & Inclusion – European Commission (

Last updated: September 27th, 2021   Contributors: Klara Lorenz-Dant  |  

The primary national-level strategy for forward looking long term care data policy in England is outlined in the UK Government’s Data Saves Lives: reshaping health and social care with data (DSL). DSL aims to bring a coherent data strategy to a large and diverse range of stakeholders across both health and care sectors, traditionally sectors with different data needs, different data practices and different levels of digital maturity. DSL was launched in June 2021 and aims to feed into primary legislation through the Health and Social Care Bill, and also influence secondary legislation. The strategy is being run by NHS England & Improvement following the merger of NHSE&I with NHS X and NHS Digital in November 2021.

Much of the strategy is given over to building on what it perceives as  momentum gained during the pandemic in health data. Specifically the linkage, integration, interoperability of data within health systems and between health and social care systems for the purposes of informing decisions with population health data and creating efficiencies in the aggregation and use of health data by researchers.

One chapter of seven is given over to long term care, Chapter 4 Improving data for adult social care. General commitments are made to addressing the following issues: access to basic information for providers of adult social care; addressing gaps in data collected by local authorities (for instance, all those they don’t fund);  integration of health and social care data; expanding the use of care technologies. The problems are discussed at a high level and financial costings, committed budgets and delivery dates are not included and have been absent from subsequent policy announcements on social care planning and spending.

A survey and consultation on the strategy ran throughout the summer of 2021 and attracted submissions from a broad set of stakeholder organisations such as health and care think tanks and data specialists such as the Information Commissioners Office, The National Data Guardian and the UK Pandemic Ethics Accelerator.

A webinar hosted by LTCcovid on 18th October 2021 brought together a panel of leading practitioners and academics from different parts of social care and across the UK. They identified seven data issues for policy makers working on digital transformation in the sector:

  • Lessons about social data use during the pandemic are not agreed by everyone. For instance, data infrastructure such as the adult social care capacity tracker has had unforeseen consequences such as increased burdens on staff. These are often unacknowledged in plans for future data policy.
  • The continued lack of data on people who pay for their own care or do not receive services from local authorities remains a priority issue across social care.
  • Tensions between conflicting desires for private data, more data, minimal data and no data must be addressed in future policy plans if trust in public social care data is to be built.
  • New tensions have arisen due to decisions that are being made with the data today that were not agreed with the providers from the start.
  • At the same time, robust data infrastructures are a prior condition of wider reform across UK social care, critical for anticipatory appraisal, ongoing monitoring and evaluation of innovation in services and practices.
  • Opportunities for optimism include building social care data that is designed around the wellbeing of people in communities – such data would go beyond the existing principles and values of population data in health to report on the relationships and values that matter for care.
  • For this, new measures with which to assess data quality and new ways of assessing and improving data operations within councils will be needed.

Last updated: December 20th, 2021   Contributors: Cian O'Donovan  |  

Contributors to the LTCcovid Living International Report, so far:

this list is regularly updated to reflect contributions to the report, if you’d like to contribute please email

Elisa Aguzzoli, Liat Ayalon, David Bell, Shuli Brammli-Greenberg, Jorge Browne Salas, Jenni Burton, William Byrd, Sara CharlesworthAdelina Comas-Herrera, Natasha Curry, Gemma Drou, Stefanie Ettelt, Maria-Aurora Fenech, Thomas Fischer, Nerina Girasol, Chris Hatton, Kerstin HämelNina Hemmings, David Henderson, Stefania Ilinca, Margrieta Langins, Shoshana Lauter, Kai Leichsenring, Elizabeth Lemmon, Klara Lorenz-Dant, Lee-Fay Low, Joanna Marczak, Elisabetta Notarnicola, Cian O’DonovanCamille Oung, Disha Patel, Eleonora Perobelli, Daisy Pharoah, Stacey Rand, Tine Rostgaard, Olafur H. Samuelsson, Maximilien Salcher-Konrad, Benjamin Schlaepfer, Cheng Shi, Cassandra Simmons, Andrea E. SchmidtAgnieszka Sowa-Kofta, Wendy Taylor, Thordis Hulda Tomasdottir, Sharona Tsadok-Rosenbluth, Sara Ulla Diez, Lisa van Tol, Patrick Alexander Wachholz, Jessica J. Yu

This report has built on previous LTCcovid country reports and is supported by the Social Care COVID-19 Resilience and Recovery project, which is funded by the National Institute for Health Research (NIHR) Policy Research Programme (NIHR202333) and by the International Long-Term Care Policy Network and the Care Policy and Evaluation Centre at the London School of Economics and Political Science. The views expressed in this publication are those of the author(s) and not necessarily those of the funders.