Words to find common ground for action. Bridging social and health services through concertation on accessibility to vulnerable groups in Brussels
Authors: Vignes Maguelone , Legac Jessie 
Published: January 2024

Introduction: Linking general primary care, health and social services with non-profit organisations dedicated to vulnerable groups is the aim of an ongoing concertation process hosted by Brusano, the regional organisation aimed at fostering person-centred health and social-integrated services in Brussels.
In the Belgian Capital, the most vulnerable people are often attended to by non-profit organisations dedicated to a specific target group or problem. These organisations are often overwhelmed, with people not moving towards general services as intended at some point. General primary care and social services remain insufficiently accessible to vulnerable people. Considering the integrated health and social policy reforms currently taking place at national and regional levels, health and social professionals felt the need to better understand each other and build common ground in order to work together and participate in the reform process.
Targeted population and stakeholders: The targeted population is care providers from all levels of care, home helpers and social workers in all kinds of settings. End beneficiaries are vulnerable groups - e.g. migrants, sex workers, people with addictions, prisoners and former inmates, isolated persons, homeless people... - and people who are at a high risk of exclusion when facing problems mixing health and social situations – low income, precarious housing, language barriers... The premise is that if services can include such vulnerable groups, they might achieve broader accessibility for all.
Participants: The concertation gathers professionals from multiple health sector disciplines- primary care, hospital, mental health - as well as from the social sector and dedicated non-profits. Nearly 150 professionals participate, with a mean attendance of 30 per meeting.
Description of the initiative: In 2021-2022, the concertation resulted in an online publication, co-written by two partners, reviewed by 5 others, presented and discussed in 3 meetings, then further adjusted accordingly. The paper provides an overview of the organisation of the health and social systems, as well as a set of definitions. It acknowledges that different levels of care operate as first contact and often lack the means and skills to be fully inclusive and accessible to vulnerable groups.
Results / Impact: Stakeholders coined a new phrase - “inclusive practices” - to fully capture the expertise of the dedicated non-profits and to bring about inclusivity in different settings through collaborations. The definitions were included in the glossary used as a reference for the upcoming Regional Health and Social Policy Plan.

Learning for the international audience: Building a common language for health and social professionals, while fully recognizing the expertise of non-profits dedicated to vulnerable groups bridges the gap between health and social services. It is a step towards better integration of health and social organisations, which is a major challenge to integrated care.
Next steps: In the coming months, the concertation process will continue identifying and supporting inclusive practices whatever the service or level of care. It will be fully part of the Regional Health and Social Integrated Plan.
It develops as a model where a specific expertise supports services to the general population.