Future Care (ToekomstZorg): Workplace innovation through advancing intersectoral collaboration in long-term care in Flanders and Brussels

Healthcare systems worldwide, particularly those focused on long-term care, are under increasing pressure[i]. Due to demographic shifts and an ageing population, the demand for chronic care is growing and care needs are becoming increasingly complex. At the same time, care and support systems face mounting challenges related to resource and workforce shortages, as well as high workloads for care providers. These pressures are further compounded by a fragmented care landscape, where care and support have historically been organised across separate sectors, organisations, and domains, each with its own target groups, services, and logic. As a result, more people are falling through the cracks, and care providers struggle to deliver comprehensive support.

Addressing these challenges requires new care and collaboration models that respond to evolving needs while supporting workable conditions for healthcare professionals. Many academics and policymakers argue that future care provision and innovation must transcend traditional sectoral and policy boundaries[ii]. As the WHO states, “Multisectoral and intersectoral action is crucial to addressing many of today’s most pressing challenges” (WHO, 2014)[iii]. Intensive collaboration between care organisations, across sectors, and around target groups is therefore a key strategy for meeting the complex challenges ahead.

The future of care demands a fundamentally different way of organising, with a strong focus on the primary process of care delivery. The current healthcare landscape, characterised by sectoral divisions and specialised organisations, reflects an outdated model that no longer fits today’s complex reality. Care needs to be reorganised around the needs of a population, focusing on the client and their care requirements. This is best achieved through multidisciplinary teams that share responsibility for the entire care and support process, with sufficient decision-making authority to address complex situations and opportunities for continuous learning and professional development. This approach gives rise to new entities that transcend the boundaries of sectors, organisations and individual workplaces. Support systems and governance structures must be aligned accordingly. The result is a more effective organisational structure that keeps teams engaged and contributes to meaningful work.

The Flemish programme ToekomstZorg[iv] was established to address this organisational challenge in Flanders and Brussels by exploring future-proof intersectoral models of collaboration through co-creation between practice, policy, and science. The programme provides a framework that stimulates innovation in long-term care and enables the scaling and application of new collaborative models. At the same time, it identifies regulatory and other barriers that impede collaboration and the further development of new models.

Drawing on the sociotechnical participative methodology, regional explorations and conferences have revealed a wide range of good practices and initiatives in the field. However, these practices often remain fragmented and are not systematically embedded in routine operations. ToekomstZorg addresses this matter by combining experimentation with mechanisms for further development and consolidation, supported by regulatory flexibility and a framework with the right preconditions.

ToekomstZorg creates an innovation sandbox where organisations and professionals can explore new ways of working together, supported by scientific insights. Within the broader Innovation Sandbox, organisations can request regulatory flexibility to further develop their initiatives. In the Innovation  Sandbox ‘Plus’, a select number of mature projects can experiment with a comprehensive redesign of the core care process. In addition to regulatory flexibility, these projects receive scientific guidance, impact assessments, and financial support, ensuring that innovative solutions are both measurable and scalable. Project proposals in the Innovation Sandbox Plus must align with one of three strategic lines, each with a distinct focus. The first explores new organisational models to enhance care continuity and accessibility. The second rethinks workforce organisation through intersectoral structures. The third combines physical and digital care, using technology to support collaboration and innovative service models. The goal is not only to foster innovation, but also to enhance care quality, ensure workable conditions for staff, control costs, and improve population health. The sextuple aim[v] serves as a guiding framework for evaluating the impact of the projects.

Ultimately, ToekomstZorg aims to develop sustainable intersectoral collaboration models that support high-quality care and manageable, meaningful work for healthcare professionals. By embedding successful practices into everyday operations and, where needed, adapting relevant policies and regulations, the programme creates a resilient and adaptable long-term care system capable of meeting future challenges.