FLINT
The European Framework for Long-term Integrated care services (FLINT)
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 integrated long-term care (I-LTC) programmes by showing how various aspects—such as human, social, and organizational factors—are interconnected. This makes it easier to understand the impact of an I-LTC programme.
How was the framework developed?
FLINT is based on existing frameworks for I-LTC. Its development involved two steps:
A literature review: this identified 69 frameworks. 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. Ultimately, 15 frameworks were deemed suitable. This resulted in the identification of six domains and related items.
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, such as researchers, healthcare professionals, policymakers, and programme managers. Their expertise was essential to ensure the framework's accuracy and applicability.
The refined framework
Based on the feedback from experts, the framework was refined and expanded. 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, the new framework emphasizes the necessary contribution of the unpaid care workforce, shown in the figure by an asterisk. These improvements make the framework more representative, comprehensive, and easier to apply in practice.
A visual representation of FLINT
= Micro
= Meso
= Macro
*applies to both the paid and unpaid care workforce
People in need for care, unpaid care workforce, and communities
Engagement of person and unpaid care workforce in co-creation process
Empowerment and support for person and unpaid care workforce
Education for person and unpaid workforce
Community engagement and empowerment
Paid care workforce and service delivery
Collaborative commitment and culture*
Collaborative care activities*
Case-finding
Shared decision making*
Provision of person-centred care*
Self-management support*
Care coordinator
Interdisciplinary collaboration*
Professional development/training
Workforce retention and capacity building and planning*
Organisation of care
Accessibility*
Care transitions*
Coordination of care*
Resource management and resource coordination
Leadership
Innovation and research
Quality improvement and learning
Creating an enabling environment
Partnerships/networks*
ICT and ICT systems
Digital tools and technologies*
Interoperable information systems*
Finance
Budget for I-LTC programmes
Sustainable financing system
Reimbursement of I-LTC programmes for people in need for care
Incentive arrangements for organisations
Governance
Accountability for care processes and outcomes*
Governance and accountability arrangements
Regulatory frameworks/regulations
National/regional/local policies*
Quality assurance and improvement processes
Next steps
The goal of FLINT is to fully capture the complexity of I-LTC and improve its implementation in practice. As a next step of the project, the framework will be applied to real-world practices to identify what works well and where improvements are needed. In this phase, feedback from individuals receiving care will also be incorporated. This way, FLINT becomes a practical tool for delivering better care.
Further information
A scientific paper on the FLINT framework is currently in preparation and will be shared on this page once it is published and via LinkedIn and our newsletter.
For inquiries about the FLINT framework, please contact Ms. Dr. Anam Ahmed (anam.ahmed@panaxea.eu) or Ms. Iris Boot MSc (iris.boot@panaxea.eu).