Two routes to integration, and what makes them hold
Italy and Portugal built integrated services for children under the same Council Recommendation (EU) 2021/1004 of 14 June 2021, by different routes. Italy built integration around each family; Portugal reorganised how existing services in every municipality work together. This activity compares the two routes and the conditions that make integration hold, or fail.
"A common thread is the shift from service-centred to family-centred logic: professionals are brought around the family, rather than the family being sent from office to office."
Two countries and the same goal. Two routes.
Next you will open each practice, dimension by dimension. Both cards use the same five dimensions, so you can compare them directly.
Around the family, or across the municipality
Open each dimension. It opens on both cards at once, so you can compare directly.
Neither route is the better one
- A structure that brings sectors together
- A named case manager
- A shared tool
- A legal anchor
- The catch
- A structure that brings sectors together
- A named case manager
- A shared tool
- A legal anchor
- The catch
Italy integrates deeply around each family; Portugal integrates broadly, by reorganising how existing services in every municipality relate to one another. The routes differ, but they rest on the same components: a legal anchor, a named case manager, a shared tool and a structure that brings sectors together.
Each route also has its own cost. Italy's model took eleven years of training and evaluation to reach statutory status. Portugal's breadth was reached in about three years, and now depends on coordination capacity to support it. Which route fits depends on the starting point: whether local partnership structures already exist, and whether there is capacity to work intensively with families.
Five factors that make integration hold
Across the practices documented in the ECG synthesis, five factors are consistently associated with integration that lasts. Open each one.
Signed protocols, memoranda of understanding and statutory frameworks are more durable than goodwill and professional relationships.
Examples
Germany's federal-state agreement under the Federal Child Protection Act; Austria's Art. 15a B-VG agreement; the Netherlands' Jeugdwet; Romania's Law 292/2011.
Common case-management and information-sharing systems embed coordination in daily practice; without them, coordination depends on individual relationships that rarely survive staff turnover.
Examples
Austria's FRÜDOK, Greece's IDIKA, Italy's RPMonline, Romania's Aurora, Hungary's TENYI.
Inter-professional training builds the capacity to see the child as a whole rather than only parts of it. Focal points identify it as the most indispensable factor and the most underinvested.
Examples
In Finland, building a shared understanding among professionals took approximately ten years.
A case manager or team with explicit accountability for the whole child is present in every high-performing practice.
Examples
Romania's MPS names the case manager from within the community team; Portugal always assigns case management to a municipal employee, typically a social worker or psychologist. In both, the case manager holds direct responsibility for the family.
Short funding cycles undo integration: cross-sector trust takes time to build, and networks dissolve quickly when funding ends.
Examples
P.I.P.P.I. is financed from two national sources; Portugal's local units run on the regular budgets of their partner institutions.
"Integration without a clear coordination locus tends to dissolve under operational pressure."
Something is not holding
Each situation is illustrative and draws on patterns described in the ECG synthesis. Select up to two factors that are missing, then confirm to read the feedback.
Scenario 1 · The network that dissolved
A three-year project built strong working relationships between the school, the health centre and social services in one district. When the funding ended, two coordinators left and the joint meetings stopped within six months.
Short funding cycles undo integration: trust across sectors takes years to build, and practitioner networks dissolve quickly when funding ends. In Italy, recognition as an Essential Level of Social Provision obliges the State and Regions to fund P.I.P.P.I., and financing now comes from two national sources.
Scenario 2 · The files that do not travel
Responsibility for vulnerable families has moved from a national agency to the municipalities. Case files were not transferred, and each family's history has to be requested case by case.
Data sharing between sectors is the most significant operational barrier identified across the documented practices. Portugal faced this after the 2023 decentralisation of social action to municipalities; the National Coordination now sends each local unit three lists from the Social Security database to reconnect families to casework.
Scenario 3 · The family outside the meeting
Social workers, health visitors and teachers attend a monthly coordination meeting. Each still assesses the child against their own sector's criteria, and parents are told of decisions after the meeting.
Meeting together does not necessarily mean working together. Italy addressed professional resistance to family participation through structured, evidence-based training and tools that let practitioners share assessments with families in real time; the family became a formal member of the team.
Structures, not goodwill
In each of the three situations, integration depended on people rather than structures. The mature practices are built on structures that make working together the default: an agreement, a tool, a named case manager, stable financing and shared training.
"The common thread is early investment in a shared tool or platform that makes collaboration structurally easier than working in isolation, rather than relying on professional motivation alone to sustain integration over time."
Three things the evidence shows
There is more than one route to integration.
Deep integration around the family and system-level coordination of existing services both work; the starting point decides which fits.
Integration holds when it rests on structures, not goodwill.
A legal anchor, a shared tool, a named case manager and stable financing keep services working together when people and budgets change.
Professional culture is the slowest factor and the most underinvested.
Joint training is what allows professionals to see the whole child, and it takes years, not months.
Apply this to your context
If you work at national level
- Which route fits your starting point: are there local partnership structures that could host integration?
- Which of the five factors is weakest in your system today?
If you work at municipal or service level
- What keeps services working together: an agreement, a tool, or people?
- Does each family you work with have one named case manager?
- When did professionals from different sectors last train together in your area?
Take this to your team: two routes, five factors
Italy and Portugal built integrated services for children under the same Council Recommendation, by different routes: Italy around each family, Portugal across existing services in every municipality. Both rest on the same building blocks, and both show what happens when one of them is missing.
Three things the evidence shows
- There is more than one route to integration. Deep integration around the family and system-level coordination of existing services both work; your starting point decides which fits.
- Integration holds when it rests on structures, not goodwill: a legal anchor, a shared tool, a named case manager and stable financing.
- Professional culture is the slowest factor and the most underinvested. Joint training is what allows professionals to see the whole child.
Questions to use with your team
- Which route best fits our starting point: deep integration around families, coordination of existing services, or a combination?
- Which of the five factors (formal agreements, shared digital infrastructure, joint training, a named case manager, sustainable financing) is weakest in our system?
- If our current project funding or our key coordinators left tomorrow, what would keep services working together?
- Who is accountable for each family across sectors, and how do they share information lawfully?
- When did professionals from health, education and social services last train together? Who would fund and organise the next session?
The point of this card is to open a cross-sectoral conversation, at national or municipal level. Bring it to a working group or a team meeting and start with the first question.