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The Move to Community-Based Care: Is Ireland Ready?


The population is living longer, enabled in part by advancements in medical and health technology. The average age expectancy in Ireland is now 81 years, compared to 100 years ago when people lived until just their early 50’s. However, not all people living into their 80’s enjoy good health, with many living with co-morbidities and requiring complex care interventions. It is internationally recognised that an urgent shift to a community-based model of care is necessary to meet the rising needs of elderly patients, freeing hospitals to focus on the provision of acute and specialist services. We look at what measures need to be put in place to ensure that this transition will deliver a sustainable model of care into the future.


What are the goals?

  • Move care from the acute setting to deliver well-resourced services within the community
  • Facilitate coordinated care as a means to improve continuity and guarantee good patient outcomes
  • Support the community nursing workforce to become leaders in this area
  • Improve the status of home care as a profession


How can these be achieved?

  • Develop a whole-system approach with strategic workforce planning and hospital restructuring
  • Involve nurses in supporting and promoting better coordinated care
  • Invest in the appropriate education and training to upskill nurses transferring from the acute to the community setting
  • Ensure homecare staff are properly supported and competitively paid


An urgent need

Community and specialist nurses will be the key to ensuring successful, long-lasting reform in the area of complex care. While the shift to this model of care is inevitable, driven by global forces, what is not yet certain is how that care is going to be properly delivered in the long-term to meet patients’ growing needs. Dementia is now posing a significant burden to health and social care systems throughout the world, with an estimated 36 million people currently living with the condition, and this figure expected to rise continually. The Irish National Dementia Strategy (NDS) has committed to caring for people with dementia in their own homes for as long as is viable rather than keeping them in residential care.


The reality we face

The Health Service Executive (HSE), which currently delivers most of the country’s care services, drafted national quality guidelines for homecare support in 2008. While these are being implemented, they are not yet finalised. Homecare for the elderly is a rapidly advancing sector in Ireland, but remains unregulated and requires legislation to guarantee the rights of both patients and their carers. Aoife Smith, author of Migrant Workers in the Homecare Sector: Preparing for the Elder Boom in Ireland, states that “logical forward thinking” is required as opposed to the current ad-hoc approach:

  • Homecare packages – provided free by the HSE irrespective of income, but with demand outstripping supply, there are long waiting lists for these assistances. Care typically amounts to a couple of hours in the morning and afternoon.
  • Home help – provided to older people without a medical card at a cost, and amounts to half an hour per day
  • Nursing home care – involves a mean test if the older person wants the average weekly fee of €1200 subsidised by the state.


A step in the right direction

In April this year, the Department of Health published a report based on the Health Research Board’s review of elderly homecare provision in Ireland; it revealed that statutory schemes which support older people to live out their lives in their own homes are under increasing pressure in other European countries, concluding that pensioners would be required to contribute to the cost of their own homecare.

Minister for Older People, Helen McEntee stated that it was her priority to ensure that our ageing population get the best level of care possible:

“Unfortunately, as a country, the only statutory scheme we have in place at present to care for our elderly is the Nursing Homes Support Scheme – A Fair Deal. I am determined to change this and to establish a new statutory homecare scheme…The development of this scheme is complex. We need to get it right.”


Contact Us

Interested in a career in homecare? TTM Healthcare is continually recruiting for the best health and social care positions throughout the country. Contact us today to discuss your next move.



Evelyn Moriarty, Content Specialist

Evelyn Moriarty is a Content Specialist at TTM Healthcare, based in at our Irish headquarters. Joining the company in 2016, Evelyn specialises in both on and offline content creation for the health and social care market.

Company Bio

TTM Healthcare is a specialist health and care recruitment company established by Brian Crowley in Ennis, Co. Clare in 2002.  Now recruiting highly skilled medical professionals from all over the world, TTM has offices in Ennis, Dublin and the UK. Selected as Ireland’s No 1 Healthcare Agency by the National Recruitment Federation, TTM is also the UK’s Recruiter Awards Public Sector Agency (2016) and Professional Services Agency of the Year (2016 & 2017), as well as a Gold Standard Deloitte Best Managed Company (2016 & 2017.)



Posted in: Ireland, Nursing, Recruitment