Our healthcare system is highly stressed, both in the care setting as in terms of budgets. We must reassess healthcare in an intelligent and efficient manner. Regardless of the important healthcare improvements achieved in the past 20 years, out health system still presents structural challenges. The latest report by the OECD, “State of health in the EU. Spain, National Health Profile for 2021” (1) states that there is still a reduced number of nurses in our country (the rate is very inferior to the European mean), and the health expenditure per capita and overall is inferior to the mean in the European Union countries (2,488 € vs. 3,523 €/patient). On the other hand, during the pandemic it has been clear that there is a need for improvement in “healthcare” in all care settings.

During the final act for the Nursing Now campaign, which was held in the Ministry of Health on December 20th, 2021, the Spanish Minister of Health, Carolina Darias, announced the creation of the “National Care Strategy”, which represents a major opportunity for collaboration between autonomous communities, as well as professional and patient associations, among other agents, in order to improve care. This strategy must be led and managed by nurses, as they are responsible for patient and citizen care, offering first line support to healthcare professionals. Its final objective is to improve the quality of care, person-centred, and to contribute to sustainable healthcare development and social wellbeing.

Care is defined as the timely, fast, continuous and permanent assistance, targeted to solving specific problems which affect the personal dimension of those individuals demanding some service (Ministry of Health, 2009). Care is a multidimensional activity targeted to all persons, at all times of their life cycle, in order to maintain health and life. As a science, Nursing cares by facilitating the wellbeing of individuals, families and communities, through evidence-based practices. Its practice includes autonomous and independent care, offered to people of all ages, to healthy or sick families, groups and communities, in all settings; this includes health promotion, disease prevention, and care for ill, disabled, and dying people (ICN, 2002) (2).

The persistent pandemic has shown the strengths and weaknesses of our health system. The pre-COVID scenario maintained a curative, reactive approach to care, focused on the disease, with fragmented activities of care, even uncoordinated and ruled by professional individualism. On the other hand, the post-COVID view of healthcare must increase its population-focused, proactive and preventive approach, led by an interprofessional team based on competence (knowledge, skills and attitudes), integrated into networks, focused on measurable results for wellbeing, health and economy, and with an active participation by patients and citizens.

In order to improve care, it is essential to form a panel of experts from different settings, such as Primary, Specialized and Sociosanitary Care, as well as from academic, management and research areas, alongside representatives from society, patients, and other healthcare professionals. This panel should be the starting point for the National Care Strategy, articulating the actions for care improvement in social and healthcare sectors, and reinforcing collaboration and strategic alliances, and care based on best practices. Besides, it will be oriented according to the evaluation of interventions, monitoring of care provided (research and planning of care which will identify unwanted deviations from excellent care), and the adaptation of care based on surveys conducted on providers, professionals, patients and citizens (person-centred care). Summing up, it must provide an ecosystem of health and social care which optimizes its performance, both for professionals and for patients and citizens. It is essential to accept that persons (patients or users) are the main actors in health and social assistance, and this will require to abandon the current paternalistic attitude, in order to co-create and innovate in a close and humanistic manner, anticipating needs, connecting Primary Care with home care to a higher extent, and redefining the roles in the healthcare team, in order to encourage autonomy of management to improve care and reinforce health and social assistance.

Nurses are positioned as drivers of change in the National Care Strategy, due to their demonstrated competence and commitment; also due to their clinical experience, open mind, holistic view of the complexity of care and capacity for team work, and their empathetic and respectful attitude, with active listening, which conveys union between patient and family, as well as their fast adaptation to change, with sustained and constant alertness towards the needs of persons in order to respond to them, streamlining those resources required. On the other hand, nurses keep their commitment to solve health inequalities in collaboration with other experts, and have become a trusted voice for the society.

The recommendations by Nursing Now Spain, which incorporate the knowledge acquired during the Spanish experience of the COVID-19 pandemics, put forward five Nursing actions which are essential for the National Care Strategy:

Faced with the urgent need to implement actions for improvement in Health Care, these proposals could be the basis for defining the “Nursing Care Strategy”, expected to have a noticeable impact on the health and wellbeing of citizens, and for the economic and social development of our country.