Reforming Long‐Term Care Provision and Work in Post‐Pandemic Times: Scope and Drivers of Policy Change in the Spanish Decentralised System

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ABSTRACTThe COVID‐19 pandemic unveiled and magnified structural challenges of long‐term care (LTC) provision and work across Europe, bringing the need for reforms on the quality‐of‐care provision and work to the fore in several countries. Focusing on the case of Spain, this paper analyses to what extent the window of opportunity opened by the pandemic resulted in structural LTC reform, focusing on the scope and drivers of policy change/continuity. Relying on a multidimensional framework to analyse policy change, we performed qualitative policy analysis to assess our expectations on the mechanisms facilitating/hindering policy change in the country, where a reform process on LTC provision and work took place between July 2021 and June 2022. Our findings reveal that the pandemic fostered a radical policy change; yet, its scope was constrained by the opening of veto points, partisan incongruence, and financial limitations. The reform led to the introduction of a new care model and a new configuration of service provision. However, results were mixed, with some areas only seeing incremental adjustments due to resistance from vested interests and institutional veto players operating along the country's multi‐level governance of LTC. Our findings contribute to understanding welfare policy change beyond the ‘expansion–retrenchment’ debate, delving into the complexities of pursuing crisis‐induced reforms on LTC provision and work in decentralised welfare systems.