[Barriers and challenges of care coordination in the Spanish National Health System. SESPAS Report 2026]

Coordination is vital for the effective performance of health systems. This paper examines the barriers and challenges of care coordination in the Spanish National Health System (SNHS), exploring their root causes to provide insights for improvement. First, it analyses coordination issues common to all organizations, followed by health sector-specific barriers, particularly between primary care and hospital care. Finally, it addresses the challenges of social and healthcare coordination. In conclusion, three critical barriers to care coordination in the SNHS are identified: 1) the weakness of primary care, which limits its leadership role in patient care; 2) the governance issues within the SNHS organizations and centres; and 3) the insufficiency of resources for home, social and health care and long-term care. The relevance of ethical commitment and professionalism in ensuring high-quality, well-coordinated healthcare is emphasised.