Identified by ELA as a priority area for this year, long-term care (LTC) is at the heart of this new report which provides an in-depth analysis, from an employment angle, of the sector’s main characteristics and challenges across EU Member States. As outlined in the Council Recommendation on access to affordable high-quality long-term care, LTC refers to “a range of services and assistance for people who depend on support for daily living activities and/or are in need of some permanent nursing care”. LTC is also enshrined in Principle 18 of the European Pillar of Social Rights, which states that everyone has the right to affordable long-term care services of good quality, in particular home care and community-based services.

In Chapter 2, dedicated to an analysis of LTC workers, cooperatives are cited, together with associations and partnerships (which refers to the involvement of employers, training providers and public authorities within the framework of the Pact for Skills) and similar entities, as the main employers in the field of residential care activities and social work activities without accommodation in the vast majority of EU Member States. In fact, the share of this group of organisations, as well as the share of the people they employ, is greater in the care sector than their presence in the economy as a whole, reflecting the sector’s strong link with the social economy. According to the available data, this is particularly the case in Italy, the Netherlands, Slovenia, Luxembourg, Croatia, Lithuania and France.

Chapter 3, looking at recruitment in LTC, presents the Italian social cooperative ‘Anziani e non solo’, based in the Emilia-Romagna region and affiliated to CECOP’s member Legacoop Sociali, as a best practice. The cooperative offers specialised language training for employees, focusing on communication with care recipients and their families, emergency protocols and healthcare terminology. Acquiring language skills through this tailor-made training has enabled workers to gain greater confidence, be more engaged in their relationships with employers and care recipients, and better cope with paperwork.

As highlighted in the report, the peculiar structure of the LTC sector – characterised by a large number of cooperatives, partnerships and associations – must be taken into account by public authorities in their approaches. In this regard, CECOP, as part of the European Care Alliance, co-signed a joint letter last year calling for inclusion of social and environmental considerations in the revision of the Public Procurement Directives, with a view to allowing the participation of organisations committed to providing high-quality, person-centred, accessible and affordable care. Quality care can only be ensured if LTC workers are granted fair working conditions as well as opportunities for upskilling and reskilling, with particular attention paid to gender disparities.

CECOP reiterates its recommendations ahead of the upcoming preparation of the European Care Deal, a policy document aimed at following on the 2022 European Care Strategy. CECOP hopes that all relevant stakeholders, including care cooperatives, will be involved in the implementation dialogue, which should serve as a basis for defining measures to address issues relating to the care sector and its workforce, including LTC. These measures should acknowledge and support the valuable contribution that cooperatives already provide to the sector through decent jobs and community-led quality services, as shown in our report “Cooperatives care!”.

The serious challenges posed by an ageing population – with the number of people requiring long-term care set to rise from 30.8 million in 2019 to 38.1 million in 2050, according to the Commission’s Ageing Report (2021) – make investment in the sector an essential strategy for strengthening LTC. In a joint statement published in October 2025, the European Care Alliance called on the EU legislators to clearly earmark funding for social and care policies within the next Multiannual Financial Framework 2028-2034, explicitly mentioning and incorporating the objectives of the European Care Strategy into the National and Regional Partnership Plans (NRPPs) and the European Social Fund.

CECOP welcomed the recognition of the role of cooperatives by a key EU agency such as ELA and will continue to work towards ensuring that their contribution to LTC and, more broadly, to human health and social work is valued.