Integrated community services replace fragmented provision, in which a family tells its story at four or five separate offices, with one team, one assessment and one plan. The countries that made it function invested for years in the governance behind the services, before or alongside the services themselves. Finland's integrated service model for all children from birth to age 18 and their families works as a networked set of services operating across multiple sites, with shared management oversight; Italy made families formal members of the team and turned an eleven-year research project into statutory law; Romania built its model on a community team covering social, health and education with a shared digital tool, and moved from a 45-community pilot to national law in six years. Building a collaborative culture is the part that takes longest and meets the most resistance from systems and professionals.
Build the service that families experience as one
Three applied activities from the same evidence base: test two systems against the four questions that separate integration from its label, compare the routes Italy and Portugal took and find what makes integration hold, and lead a pilot through eight years of decisions towards a permanent national service.
The trap: symbolic compliance
A family with overlapping needs, say a health concern, a child falling behind at school and a housing problem, tells its story at four or five different offices, and is visited at home by professionals who do not know about one another. The National Action Plan names “integrated services”, but nothing has changed in how this family experiences the state. This is the risk the Recommendation itself carries: because it leaves design to Member States, “integrated community services” can become a label attached to pre-existing arrangements, with no substantive change in how services are delivered or experienced.
Three structural reasons keep recurring.
First, integration lacks a legal or political anchor. Where integration rests only on a project or a strategy, it has no stability and no continuity. Each of the successful documented practices in Member States began with a formal mandate or achieved one during implementation.
Second, the governance boundary between sectors at management level stays uncrossed. Health, education and social protection hold separate budgets, information systems and reporting lines. Where integration is attempted only among frontline staff, without aligning the managers and directors who control those systems, professional integration cannot be sustained.
Third, commitment is shorter than the change requires. Programmes designed and funded for one electoral cycle end before integration matures. Scaling typically takes 6 to 11 years, spanning several electoral cycles. Sustainability needs a political commitment that lasts as long.
The rest of this brief addresses one question: what does it take to build integration that families experience in practice, and in what order?
“The countries and practices that have moved furthest toward genuine integration share a common pattern: they invested over years in the governance architecture that makes integration possible before, or alongside, investing in service design.”
Three axes, one case manager, four questions
Integration under the Child Guarantee operates on three axes, and a plan should take all three into account. Horizontal integration is cross-sectoral policymaking at national level, with a designated lead institution, a formal interministerial agreement, and a shared monitoring framework holding all ministries to common outcomes. Germany demonstrates this by anchoring its model in a federal-state administrative agreement that obliges health and child protection authorities to co-finance and co-plan. Vertical integration synchronises national mandates with regional and municipal delivery. Local and regional authorities carry the largest part of transposing the provisions into reality, which needs fiscal transfers calibrated to need, shared standards, and capacity support for weaker municipalities. The Netherlands illustrates this through national legislation that sets the entitlement framework, while municipalities hold both the budget and the operational responsibility for youth care. Operational integration is the frontline model families encounter: a single multidisciplinary team, one assessment, one plan, rather than agencies in sequence. Finland co-locates services under one roof, and Romania’s community team acts as a single point of contact. Where all three align, the plan reaches the child; where one is missing, it can hold back the other two.
At the centre of every functioning model is case management: a named case manager who coordinates assessment, planning, delivery, monitoring and review on behalf of a child and family across sectors, so that families do not navigate fragmented systems alone and no child falls through the gaps. To show that a practice is integrated, and not only rhetorically aligned, it should answer four questions: who is the case manager, how is data shared lawfully, what links the National Action Plan to local delivery, and how is the effect measured?
Services under one roof, open to every family
A mature operational model: co-location plus universal framing.
Finland’s Family Centres co-locate maternity and child-health services, social work and parenting support under one roof, designed as open meeting places any parent can use. The universal framing normalises service contact, removes stigma, and lets struggling families seek help without being labelled. The model was co-designed over roughly a decade of monthly national-regional meetings, drawing on Sweden, Norway and the Netherlands, and the 2023 Sote reform created the county-level architecture for permanent integration. Practitioners describe the shift to “seeing the whole child” as taking close to twenty years.
What transfers: universal, open-access framing to reduce stigma and increase reach; management-level governance as the precondition for frontline integration; adapting an imported model to your own governance gaps rather than copying its features.
The catch: roughly two decades of culture change and eight years of sustained government funding, until counties and municipalities absorbed the costs. The 2023 reform split social and health (22 counties) from education (more than 300 municipalities), and there is still no nationwide evaluation.
The family as a member of the team, and a pilot recognised by law
Turns participation into a formal role and shows the full pilot-to-statute pathway.
Italy’s P.I.P.P.I. programme makes the family a formal member of the multidisciplinary team, co-authoring its own intervention plan rather than receiving an expert-led one. It is the methodological innovation with no direct parallel among the documented practices, and one that the programme’s data link to better outcomes. Built on the “World of the Child” assessment framework and the RPMonline platform, and backed by LabRIEF at the University of Padova, the programme combines a participatory intervention methodology, a structured multidisciplinary team model, continuous professional training and a rigorous evaluation framework. Italy spent eleven years moving from a research project to a statutory Essential Level of Social Provision: a decade of building political support, generating evidence, training a professional community, and surviving several changes of government. Reported results include statistically significant gains across seven cycles and a 2.1% institutionalisation rate.
What transfers: family participation operationalised as a formal team member, with the tools and training to make it count; a shared assessment platform from the start; the community of practice and university partnership that secure quality; legal embedding.
The catch: eleven years and sustained multi-government commitment to reach statutory status; a patchwork of funding still being made predictable; and strong regional inequality between north and south, which made legally defined essential levels necessary in the first place.
A multidisciplinary team, a shared tool, and a six-year path to law
Delivers integration without buildings. The most transferable model for lower-resource and rural contexts.
Romania’s Minimum Package of Services model is built around a community team, typically a community social worker, a community nurse, and a school counsellor or mediator, which is the single point of contact for families: joint assessments, shared individual case plans and shared follow-up. The community teams were backed by county coordinators offering methodological support and supervision, and their work ran through the digital case-management tool Aurora. The Bacău pilot across 45 communities over three years reported a 60% reduction in school drop-out, 50% fewer adolescent mothers, a 40% decrease in unvaccinated children, and positive movement on 22 of 33 tracked vulnerabilities. It moved from pilot to national law in six years with all-party support, and is scaling towards 2,000 rural communities.
What transfers: integration without co-location, with a small multidisciplinary team as the point of contact for families; a shared digital case-management tool and a structured training curriculum; a data-driven risk index for territorial targeting; a documented six-year pilot-to-law advocacy pathway.
The catch: the pilot was UNICEF-led, which secured training and coordination across 45 communities; at a national scale of 2,000 that intensity is hard to reproduce; continuing community-worker salaries once project funding ends proved difficult; and scale-up through ESF+ is not the same as continuing the project, since it brings different ownership, incentive and capacity constraints.
What makes adoption work
- Integrate governance at management level before the frontline. The most common failure is investing in multi-professional teams without aligning the managers, directors and ministry officials who control budgets and information systems. Frontline integration cannot outlast a governance boundary left uncrossed above it.
- Commit for several electoral cycles. None of the documented case-study practices reached national scale within a single government term. Short-term project funding is structurally incompatible with the change integrated community services require.
- Make family participation real, with method and training. Real participation of families and children needs specific methodological tools, training and accountability on the professionals’ side. Italy’s data show that families who co-author their plans achieve significantly better outcomes than those in expert-led models.
- Design monitoring and data systems from the outset. The largest systematic gap across the 29 documented practices is the absence of comparable outcome data. Practices that invested early in a shared platform and in validated assessment tools that frontline staff can administer can now generate the evidence that sustains political and financial commitment.
What gets in the way
- The pilot-to-scale gap. A model that performs in a well-resourced pilot is not the same at national scale. Romania’s pilot was UNICEF-led across 45 communities; reproducing it across 2,000 communities is a more demanding task. Portugal’s national coordination team says it would slow the rollout if it started again: it prioritised national coverage over depth and, with about four staff, cannot fully support the 164 units now in place.
- Silos persist at the frontline and, more persistently, at leadership level. Professionals are trained to see only their own part of a child’s situation; shifting to the whole child is a cultural change that took Finland around twenty years and still needs work. Coordination has to be built at management level too, not only at the front line.
- The funding cliff and split employment. Finland had eight funded years, then counties had to absorb the cost. In Romania the community team answers to up to three employers, and the poorest municipalities cannot sustain community-worker salaries once project funding ends.
- Families who are not identified cannot be supported. Where municipalities lack a child-specific social diagnosis, or a lawful basis to share data, the most excluded families stay invisible to services. In Portugal, benefits are attributed automatically on the basis of tax data, families often do not know they are in the scheme, and only about one in ten responds to outreach letters.
What transfers, and how
A legal or policy anchor is the strongest predictor of survival. Legal embedding, whether recognition in primary legislation or as a statutory service with a budget line, is the single most powerful predictor of long-term viability, regardless of how good the model is. Every documented case-study practice began with or achieved a formal mandate.
Build on existing local infrastructure, not parallel structures. Portugal reached 129 local units in under two years by embedding them in the pre-existing CLAS social network. Countries with local social-planning bodies or family-support networks should activate them rather than build new institutions, which is slower and more costly.
A shared digital case-management tool makes integration structural. Aurora and RPMonline embed cross-sector coordination in daily practice, so collaboration no longer depends on individual relationships that dissolve with staff turnover.
Universal framing reduces stigma and widens reach. Designing services for all families, not only vulnerable ones, as Finland’s open meeting places and digital family centres do, normalises service contact and lets struggling families seek help without being labelled.
At this stage the main constraint usually lies in the governance boundary between the social, health and education systems, less in the service model. The starting position resembles the pilot stage of the documented countries: services delivered by sectors, integration named in the plan but not yet built into how families experience services, and no budgetary commitment for integrated services. The transferable first move is to align managers and directors across sectors and to plan the pilot-to-law pathway.
“Integrated community services for children are not a technical solution to a service delivery problem. They are a political and governance commitment to the proposition that every child, regardless of where they live, what their family situation is, or what combination of needs they present, should be met by a coherent, coordinated, family-centred response from the state. Making that commitment real, in legislation, in budgets, in professional practice, and in the daily experience of the most vulnerable families in the EU, is the work of the European Child Guarantee.”
Transferability tags
Sources and depth
- Documenting experiences of the European Child Guarantee: Synthesis Report, Integrated Community Services (2026)EN