Ministers for Health welcome publication of ESRI’s Health Service Capacity Review report on future capacity requirements for Older People’s Care
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From: Department of Health
- Published on: 30 June 2025
- Last updated on: 30 June 2025
Minister for Health, Jennifer Carroll MacNeill, and Minister for Older People and Housing, Kieran O’Donnell, have today welcomed publication of the third of three national Health Service Capacity Review reports produced by the Economic and Social Research Institute (ESRI), on behalf of the Department of Health.
The ESRI report projects future demand for older people’s services (long-term residential care and home support) in Ireland to 2040, indicating that a substantial increase in capacity will be required to meet the demands of our growing and ageing population.
The population of Ireland aged 65 years and over is projected to increase from 0.78 million to over 1.3 million between 2022 and 2040, with the overall proportion of the population aged 65 and over projected to increase from 15% to 21%. Additionally, the population aged 85 years and over is projected to more than double between 2022 and 2040. The older age groups tend to use healthcare services more frequently and for longer durations and are significant users of long-term residential care and home support.
The ESRI report projects that the number of long-term residential care beds will need to increase by at least 61% by 2040; short-term residential care beds will need to increase by at least 72% by 2040; and home support hours will need to increase by at least 57% by 2040.
Minister Carroll MacNeill said:
"I thank the ESRI for this report, along with their other reports, it will help us plan better and be better prepared to respond to the challenges we face in meeting the needs of our growing and ageing population.
"The 2025 Programme for Government promises to build more public nursing home beds, create a homecare scheme to help people stay in their homes longer, and increase home care hours.
“We are already making progress in increasing both residential care capacity and home support hours for our older population. This is shown by the €4 million allocated in Budget 2025 to staff and open 615 new community beds. The Department of Health and the HSE are also working on a new Long-Term Residential Care Additional Capacity Plan, to be published in 2025.
“Improving access to home support is a top priority for this government. Home support hours have increased every year since 2020, from 17.8 million hours in 2020 to about 23.8 million hours in 2024. The 2025 budget for home support is the largest ever at around €838 million, allowing us to increase home support hours to about 24.3 million, helping around 60,000 people by the end of the year.
“This Capacity Review, commissioned by the Department of Health and the HSE, shows our commitment to planning based on evidence. With the Hippocrates Projection Model and our ongoing work with the ESRI, we can adapt our plans to new data and policies as they come up."
Minister O’Donnell said:
"As Minister for Older People and Housing, I welcome this ESRI report, which highlights the residential care and home support capacity that will be required to cater for our increasing older population into the future. This evidence base is crucial for future planning, ensuring we provide the right health and social care services, in the right locations, for our older people.
“The Department of Health is committed to building a demand and capacity modelling capability, necessary for any modern health service, as part of its ongoing collaboration with the ESRI. The report being published today is the third of a series of Capacity Review reports on Ireland’s health service. Today’s report on older people’s care follows the reports on acute care and GP services, with regional analysis being developed for later this year.
“It is evident that significant action will be required by Government in order to ensure that the appropriate care services are available for our older population and to deliver on Programme for Government, Sláintecare, and Project Ireland 2040 commitments. I am absolutely committed to ensuring that this capacity planning is advanced in 2025."
Notes
2018 Capacity Review
The last Capacity Review was undertaken in 2018 to project future capacity requirements for the Irish health service. That review concluded that in all scenarios, there would be increased demand and also that significant reform was required.
The 2018 Review is now considered to be outdated and no longer fit for purpose. It did not include regionalisation, investment and demand shocks from COVID-19, or macroeconomic, demographic and cost shocks. We also have a changed – and changing – health and demographic landscape; with a growing, ageing and more diverse population combined with policy responses that have been developed as part of Sláintecare which need to be considered in our long-term planning (for example: urgent and emergency care, waiting lists programme, elective care).
2025 Capacity Review
The Department of Health and the Health Service Executive (HSE) engaged ESRI as part of the Department of Health-ESRI ‘Joint Research Programme in Healthcare Reform’ to undertake a new Capacity Review to inform long-term strategic planning. The ESRI has built out their Hippocrates projection model that provides base year estimates and projections of demand, capacity and expenditure.
The Hippocrates projection modelling estimates activity rates in a 2022 baseline by age and sex. Demand is then projected by multiplying activity rates by projected population in 2040. Various assumptions and scenarios are applied to give a range of projections for services and bed capacity. The health services experienced significant disruptions to the usual trends in activity across COVID-19, and while services are recovering, the environment for future planning was more uncertain for the 2025 Capacity Review than for the 2018 Review.
The 2025 Capacity Review is projecting future demand (to 2040, at a National and Health Region level) for:
(1) Public Acute Hospitals
(2) General Practice services
(3) Older Persons services
The ESRI is publishing national capacity projections over the course of May and June, with regional projections to follow later in the year. ESRI will also update the Hippocrates Query Interface (a version of the model with more limited functionality available to officials) for inclusion of latest available data.
The Capacity Review has identified the need for more detailed consideration of the capacity requirements for a number of areas of healthcare delivery. In 2025 and 2026, the Joint Research Programme will examine Occupancy Rates, capacity requirements for Short-stay, Rehab and Day Centre Care services and capacity requirements for Critical Care. These research projects will inform future capacity planning. Other areas of focus will be identified on an annual basis in line with strategic requirements of the health service.
The Capacity Review will not be a one-off standalone piece of work, but rather the Hippocrates projection model will be developed over time to allow for the inclusion of future additional data (e.g. census 2026) and policy considerations as required, to produce regular capacity projections in the future. The projections can provide us with a baseline against which we can test the impact of different interventions.