A new European initiative is bringing together older adults, caregivers and policymakers to redesign long-term care systems and close persistent gaps in access and quality for people with complex health needs.
The BUILD project, funded under the European Commission’s Horizon Europe programme, focuses on organising health and social care around older adults in a way that is personal, practical and sustainable. Its aim is to show how co-design and participatory approaches can be applied to real systems. By involving older people, caregivers, professionals, and decision-makers, BUILD is developing recommendations and actions that genuinely reflect users’ needs.
This effort supports the European Care Strategy, launched in 2022, which calls for integrated and person-centred models of care to meet the growing demands of ageing populations. The European Commission estimates that by 2050, over 30% of Europe’s population will be aged 65 or above, intensifying pressure on health and social systems. BUILD extends this agenda by turning participation into practice, promoting reforms that improve well-being and reduce regional inequalities.
Through interviews, workshops and collaborative discussions, the project collects lived experiences of what helps or hinders smooth care delivery. Teams from various European regions share what has worked, what challenges they have faced, and what lessons can guide better implementation. The findings are being converted into practical recommendations on how to link services, improve communication between sectors and apply technology to benefit both care recipients and caregivers.
BUILD’s approach measures success not only through clinical and financial outcomes but also by considering dignity, inclusion, and social value. It recognises that long-term care provision differs widely across Europe, from urban centres in Germany to rural communities in Romania. A 2024 report by the World Health Organization’s European region found that people in remote areas have 20% less access to integrated care compared with urban residents, while women still provide 80% of unpaid care. BUILD integrates these realities into its framework to ensure adaptability across different social and economic contexts.
Throughout the project, BUILD is mapping existing long-term care systems and identifying where the gaps remain. Its outputs include a co-design framework and a practical toolbox to help regions enhance person-centred care. One tangible outcome is a glossary explaining the key terms of long-term care, designed to make the process more accessible for professionals, families and citizens alike.
The project builds on earlier successes such as the INTERLINKS framework of 2010, which placed older people at the centre of care pathways in 13 European countries. It also aligns with other Horizon-funded projects, including LAUREL and LeTs-Care, which explore complementary strategies to reduce inequality. Experts suggest that BUILD’s outcomes, due by late 2026, could shape national policies and reduce hospital readmissions by up to 15%, as demonstrated by pilot programmes in Italy and Spain.
“Person-centred integrated long-term care must prioritise dignity and inclusion,” said a project collaborator during stakeholder consultations. With Europe expected to need an additional 1.5 million care workers by 2030, the project highlights the importance of co-creation in building sustainable and equitable care systems.