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FINAL REPORT ON PACTE PROJECT
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| Partner | Local Finance | EU Finance | Total |
| Sweden | 16,783 | 16,200 | 32,983 |
| Greece | 8,390 | 24,593 | 32,983 |
| Finland | 16,782 | 16,201 | 32,983 |
| Germany | 16,782 | 16,201 | 32,983 |
| UK | 16,782 | 16,201 | 32,983 |
| Netherlands | 8,390 | 24,593 | 32,983 |
| Total | 83,909 | 113,989 (57.6%) | 197,898 |
C. Partner network
Background
As discussed elsewhere in this report, the subject of this PACTE project has been of
Increasing concern for governmental and non-governmental organisations in Europe in recent years. In particular, regional and local authorities with responsibility for health and social services are seeking more cost-effective approaches to providing care for an increasingly elderly population. In doing so and in the context of greater integration within the EU, local authorities are examining service patterns and innovations elsewhere in the EU to learn lessons of benefit to themselves in the formation of policies and services in the care of elderly people beyond the millennium.
What led to this particular project was the belief by all partners that potentially they have much to learn from a knowledge and understanding of how governmental and non-governmental organisations in other countries provide services for elderly people, both now and in the coming years.
This is the familiar context for the formation of the network of local authorities in this PACTE project. It was initiated by the authorities in Sweden, the eventual network resulting from their use of existing contacts with colleagues in many other regional and local governments in the EU. The six countries included in the project represent the main regions in the EU, including Greece from the Mediterranean area.
Characteristics of the co-operation network
In our view this subject is very similar to the next section on Organisation of co-operation and the network and is more usefully discussed there. It is virtually impossible to comment on the characteristics of the network without quickly entering into discussion of its organisation, its mode of operation, delegation of tasks, involvement of political representatives etc.
All we wish to say here is that the network was formed as a type of federation of equal partners, co-ordinated by the initiating partner and its head who demonstrated a strong commitment to a participatory and democratic style of project management. On the whole this worked well. Inevitably most of the tasks were performed by the professional/technical staff in the partner organisations, with political representatives regularly informed and actively involved in project activities as appropriate. This pattern of co-operation seemed acceptable to the main parties involved in the project.
II. ORGANISATION OF CO-OPERATION AND THE NETWORK
A. Project team organisation
Organisation of political partnership: This project did not require a formal organisation at the political level of the operation of the project. The operational work of the project was conducted primarily by the professional/technical staff in each partner organisation. These staff liased regularly with their political representatives, keeping them fully informed of the project's work and development. As mentioned earlier, political representatives were involved in project meetings on an 'ad hoc' basis eg. many councillors from the Municipality of Alaharma were involved in the discussions in the Finland meeting. Although there was no formal organisation at the political level, political representatives in the areas showed a keen interest and commitment to the project.
Organisation of technical partnership: The project was managed and co-ordinated by a project co-ordination group comprising the head of the project, the finance controller and a country co-ordinator from each partner. This group had executive responsibility for the project with each country co-ordinator being responsible for his/her organisation's contribution to the work of the project. The group met for planning meetings during each of the six residential seminars and on one or two separate occasions. Each partner had a project group of professional/technical staff co-ordinated by the country co-ordinator.
Distribution of tasks: This was decided by the project co-ordination group, most of the distribution being obvious and according to designated roles eg. the finance controller dealt with all matters relating to project finance. The residential seminars were a central feature of this project and were planned by the co-ordination group. The local professional/technical group assumed responsibility for detailed planning of the residential seminar. The preparation of interim reports on the project for the PACTE office were the responsibility of the head of the project.
Role of any external partners: In the last stage of the project the project engaged the services of the European Institute of Social Services at the University of Kent, UK. The Institute is currently working on an edited collection of project papers to be published by the project as a second substantive report on its work. No other external partners were involved with the project.
Mode of operation of the project team: This has been adequately explained in earlier discussion in this section of the report. The emphasis has been on an open, democratic and participatory style of operation but with clear lines of accountability. The project co-ordination group has been crucial to the operation of the project.
Internal and external communications: Again, this has been largely covered in earlier points in this section. It has been important for partner organisations to communicate with relevant individuals and organisations in their home areas and this has been done to varying degrees. For example, the care of elderly people is a major responsibility of both health and social services, and is provided by both governmental and non-governmental organisations. Project staff have therefore consulted with and involved in the residential seminars individuals from a range of relevant organisations.
Financial management system implemented: The financial management is centralised which means that the different partners are sending the invoices to the project leader and the financial manager for evaluation and payment according to the budget and the Pacte rules. The partners pay the invoices when they occur and then the project pays when money arrives from the Commission (Pacte).
From the start there was an agreement meaning that every part should pay the missing part of their share of the budget ( 25-50%) to a mutual account and then get paid with 100 % of the good invoices .Unfortunately some of the partners could not follow that agreement.
B. Any modifications or difficulties
There is very little to say in this section because there were no significant changes nor modifications to the project ie. no change of partners, no significant change in the organisation of the project - nor were any major difficulties encountered. The only possible exception to this is discussed in section III below in relation to the difficulty of being able to implement certain project objectives which proved to be over-ambitious.
It has not been necessary to request technical assistance from the PACTE office. There was a communication with the office concerning a reduction in the project budget for PACTE central costs and a more recent useful contact with the London office for advice on the format for the final report.
III IMPLEMENTATION
In our view this should be the most significant section of the report as it covers both the extent and the methodology of implementation of the project's objectives. Secondly, it addresses the very important subject of the tangible value of the project to the partner organisations. We focus substantially on these topics in the rest of our report.
A. Progress made
Project start-up: There was no delay
Joint project objectives: The initial agreed objectives of this project were as follows
a) To undertake a comparative analysis of national policies and responsibilities for caring for elderly people
b) To undertake an analysis of the impact of the increase in the third age
c) To identify issues faced by partners to date and exchange experience on how those issues were tackled
d) To identify emerging issues for partner organisations
e) To organise workshops to discuss ways of tackling emerging issues
f) To develop strategies for tackling emerging issues
g) To establish a network of contacts for possible future collaboration
As the project developed partners recognised that there was some overlap in objectives [eg. c) and d)]; objective e) was a means of implementing other objectives and was not an objective in itself; and, most importantly, objectives a) and b) were too ambitious for a project of this kind. Partners became increasingly aware of other published and on-going European work on care of elderly people, not least the work of the European Commission's Observatory on Elderly People. This body has produced regular EU-wide reviews of data concerning older people in all member States, together with reports on national polices, services and key issues facing services such as health and social care. For example, in the context of ageing populations across the EU the question of the financing of long-term care of older people is of great concern to all governments.
Projects such as this one are of most value when they concentrate on objectives c) and f), with e) and g) serving as means towards the implementation of objectives during the project and subsequently. The work of this PACTE project followed this pattern. The appendices of this report contain examples of work done by the partners in implementing project objectives.
Work programme: This point and the next one on the Schedule are best discussed in section B. of this report under Operations carried out and Results. Briefly, the initial programme was complied with as was the schedule. The main work of the project was centred on the six residential seminars, together with activities in preparation for these events and work following them. This is explained in sections B. and C.
B. Operations carried out
Obviously PACTE projects cover a great diversity of subjects so that terms such as 'operations' and 'results' have varying degrees of applicability. We interpret the terms as appropriate to the nature of our project. In this section on 'operations' we deal with the main activities of the project in outlining the subject matter and other content of the six residential workshops; and through the provision of examples of project outputs in relation to the main initial objectives.
The residential workshops
The initial plan was for one workshop to take place in each partner's area with the subject for each workshop being agreed in advance by the project's coordinating group. The workshop would involve both professional/technical staff and political representatives from the organiser's area, and would also include visits to services of special interest. The six workshops were conducted according to the initial plan, with participants recording high degrees of satisfaction.
The six workshops were:
1. June 1996 in Tjörn, Sweden.
Subjects: Economic aspects of care for elderly people; medical care;
the problem of dementia and different approaches to service provision.
2. September 1996 in Flevoland, Netherlands
Subjects: Preventative care services; care services by not-for-profit
and for-profit providers.
3. December 1996 in Haidari, Greece
Subjects: Implications of the loss of independence in old age; open
care services; the role of local authorities in elderly care.
4. February 1997 in Wurzburg, Germany
Subjects: Comparative analysis of national policies and
responsibilities; key issues faced by partners in providing care
services; strategies for tackling issues.
5. April 1997 in Redbridge, London, UK
Subjects: Care services for elderly people from ethnic minorities;
contributions by the voluntary sector in elderly care; planning and
implementing continuing care.
6. June 1997 in Alaharma, Finland
Subjects: Rehabilitation services; assessment; review of the project
including benefits to partner organisations and possible formation of
network for future collaboration.
There were inevitably some minor modifications to the subjects covered in the workshops to allow time for discussion of important questions not on the formal agenda for a workshop. In each workshop the organising partner had responsibility for a programme of lectures, discussions, visits and formal dinners which normally included political representatives.
We now refer back to the project's objectives (see III A above) and provide examples of work undertaken to implement the objectives. This work is mainly in the form of documents prepared for discussion at the workshops, with some written subsequently and circulated to participants. Some papers are included as an appendix to this report as evidence of the project's outputs. These and others will be included in the edited collection of project papers for partners to use in continuing work in this field in their own regions and countries.
Project objectives and examples of project papers:
a) Data on comparative pensions; case studies illustrating similarities and differences in countries' approaches to care for elderly people (see appendix); economic dimension of ageing (see appendix - this is one of the most substantial project papers which summarises similarities and differences in approaches to different aspects of care of elderly people in the six countries).
b) Demographic comparisons showing growth in elderly populations (see appendix); comparative data on costs of care eg. residential care.
c) Papers on dementia (see appendix); keeping people at home (community care); rehabilitation services (see appendix); elderly ethnic elders (see appendix); approaches to assessment and service planning.
d) Papers produced in relation to this objective are listed under objective c) above. The two objectives and resultant work were properly combined in project activities.
e) Please refer to the section Residential Workshops above.
f) It is difficult to point to precise project outputs on this ambitious objective. Rather than developing 'strategies' for dealing with emerging issues project partners shared experience and ways of dealing with key issues. In doing so they learned of approaches to care of elderly people in other countries which they are considering adapting for use in their own situations - see section below on partners' estimations of the value of the project.
g) Partners concluded that it is not feasible to establish a formal, permanent network resulting from the project. However, there is strong commitment to informal contact and collaboration of matters of mutual interest between two or more partners. A booklet is being prepared containing information necessary for continuation of informal collaboration ie. names, addresses, phones etc., topics. Partners will be alert to the possibilities for applying for EU funding for future work in this and other subjects.
C. Results
As discussed at the beginning of section B. 'results' have different meanings for different types of projects. We have already illustrated project outputs in relation to objectives. Here we will concentrate on results as benefits of the project to contributing partners, together with an indication of how the experience and findings of the project have been and will be made available to wider audiences.
Benefits to partners
i) One partner is currently developing a detailed plan for elderly care. This plan has clearly benefited from learning of other areas/countries approaches to certain aspects of elderly care eg. training and guidelines for professionals and volunteers working with problems of dementia. Collaboration between this partner and another will continue after the project has finished.
ii) In identifying tangible benefits of the PACTE project other partners referred to what they had learned from one another concerning:
a) the value of developing a purchaser/provider split in care services,
with greater emphasis on care provision by non-state providers;
b) the pivotal position of family carers in the spectrum of care
provision, their needs and how they can/should be met;
c) different approaches to non-residential care, costs and benefits -
including ways of reducing institutional care;
d) the structured use of volunteers in Germany to support elderly
people with dementia, and Swedish practice guidelines for work in this
field;
e) joint-commissioning framework for developing social and health care
services for older people.
iii) There were several examples of how partners will continue to benefit from the project with post-project activities eg. staff from one partner have been asked by another to provide some training on working with carers this autumn. In all partners the level of political interest and understanding has been considerably raised by the project eg. one partner is planning a symposium for local politicians as a follow-up to the project. This may be extended to include politicians from other partners.
iv) A smaller but nonetheless important benefit was that gained by many of the services and projects visited by participants at the residential workshops. They greatly appreciated being brought onto the 'European scene' through the interest shown by visitors from several European countries, and the more tangible gains of learning of other countries' approaches in discussions during the visits.
Concrete results
Example of more concrete character is the dementia guideline produced in the PACTE project and the common glossary. Even facts and figures in the economic dimension of ageing is an important part that has been worked out within the project . More information will be find in the appendices.
Circulation of results
a) During the project papers produced by participants were circulated within their organisations and local areas for local discussion and use. In some cases papers were used in regional and national meetings to illustrate approaches in other countries to providing care services for elderly people.
b) Now that the project has ended this process will continue at local, regional and national levels. The second final project (see below) will be used for the same purpose.
c) The edited collection of key project papers is currently being produced. This will be available first to partner organisations for their use and will be disseminated by them as appropriate.
IV. FINAL REVIEW
During the final residential workshop in Finland partners carried out a review and evaluation of the project. This review was in the form of a carefully structured discussion of all major aspects of the project and included all partners. The following were the main points resulting from this review:
1. The overall conclusion was that the project had been sufficiently successful in the progress made with its initial objectives. In particular, partners considered that through the sharing of experience they had learned valuable lessons for the development of their own policies and services in care for the steadily increasing numbers of elderly people in their areas. This was the main result and value of the project.
2. Predictably there were difficulties to be worked through in terms of different definitions, understandings and other aspects of the project's subject.
3. The programme of six residential workshops organised by each partner worked well, providing important continuity and a sense of joint endeavour by project partners. The format and content of the workshops was mostly very satisfactory.
4. One difficulty was that some staff from partners attended some workshops but not others. Although there was a core of participants attending all or most workshops there was some loss of continuity and cohesion because of this factor. It may be regarded as inevitable in work of this kind.
5. Partners commented on the very considerable personal commitment of time and other resources to the project by employers and individual staff involved in the project. In particular, individuals willingly spent weekends attending workshops to obtain cheaper air fares while business people are able to afford higher mid-week fares and so avoid weekend working.
6. The financial management system operated efficiently within the tight budget for the project. Partners undoubtedly contributed financially to the project well beyond their budgeted liabilities.
7. The experience of the project showed that the selection of partners for the network represented a judicious variety of organisations and countries for a project of this kind. It was particularly valuable to include a Mediterranean country.
8. The project had limited contact with the PACTE office during its operation. In relation to finance, the change in the charge for administration/overheads by the PACTE office caused some difficulties, as did delays in payment to the project. Greater clarification of the services available from the PACTE office would have been helpful. We also suggest that the Guidelines for the final report on PACTE projects could be re-drafted. They are rather repetitive in places and have a tendency to encourage length rather than quality reporting.
In conclusion
The question of further steps has been covered above in the reference to continuation of an informal network and ad hoc collaboration between two or more partners on specific follow-up work. This is a highly desirable outcome from this project.
The political dimension elderly care in Europe have been discussed during the life time of the project. One conclusion is that this project could , if there is an interest of course, be presented for the directorate that handles this questions in Brussels and the social- economic committee in some sort of seminars and Exhibition. One item on the conference could be the problems to get people working in this field and the possibilities we could have if we connect unemployed people to this sector in some sort of way .
No decision has been made yet on future applications for other Community programmes. However, there is no doubt that the experience of being involved in a successful EU funded programme such as PACTE stimulates partners for involvement in further European programmes. There are various sources of information and assistance should partners in this project wish to apply to other EU programmes.
Finally, we wish to emphasise that involvement in the PACTE project has been a very positive and valuable experience for the partners concerned. Much was learned from one another on different approaches to the care of elderly people, this learning being disseminated widely for the benefit of policy and service development in a subject of high priority for EU social policy. We wish to record our thanks to the PACTE programme for the opportunity to participate in this way.
APPENDICES
The following project papers are attached as examples of work undertaken to implement project objectives:
1. The Elderly in Europe
2. Economic Dimension of Ageing
3. Case Studies
4. Dementia Guideline
5. Special Issues: Ethnic Minorities
6. Rehabilitation of Elderly People
7. Care of elderly people in Greece
8. Caring for old people in Sweden
9. Adult Abuse: Procedures and Guidelines
10. Assessment
Folke Brolin
Head of Project
