The “increasing demand” for home support for older persons and “reliance” on the private sector were discussed at a HSE meeting last year.
According to minutes of the HSE performance committee meeting in October, members queried whether the services provided by the private sector are subject to audit.
It was highlighted to members that in some areas “there are audit team resources in place, which audit indirect service provision against the service specification”.
However, committee members were told that data was limited due to the absence of a single information and communications technology (ICT) system for home support services.
The HSE home support service (HSS) currently supports older people to remain in their own homes for as long as possible.
According to figures provided by the HSE, 25.5 million hours of home support were delivered by the HSS in 2025, an increase on 2024 figures.
Approximately 79,400 people received home support in 2025, including 21,445 people who began using the service.
The HSE National Service Plan 2026 commits to the delivery of 27 million hours of home support to 62,000 people this year.
Currently, home support is a non-statutory service and access is based on an assessment of the person’s needs by the HSE.
The Executive states that decisions are made based on available resources and competing demands.
“Despite the substantial level of service provision, demand for home support and its role as an alternative to long-stay care has grown considerably in recent years,” a HSE spokesperson told the Medical
Independent (MI). “The type of support required has also evolved into a more person-centred, personal care model.”
Home support is delivered through public provision by HSE-employed staff, voluntary not-for-profit and private for-profit providers under service-level agreements.
The HSE spokesperson noted that a recent Economic and Social Research Institute publication stated that the population aged over 65 is projected to grow from 0.78 million in 2022 to over 1.3 million by 2040. This demographic shift is the primary driver of increased demand.
The Executive spokesperson added that home support providers appointed to the home support authorisation scheme (HSAS) are legally bound by the terms and conditions of the scheme.
They are obliged to adhere to a set of 23 specifications aligned to HIQA standards.
On the ICT challenges, the HSE spokesperson said that it is completing a competitive dialogue procurement process to purchase a single national ICT system for home support services.
“The ICT system, once implemented, will deliver a digitally enabled system that will drive the national standardisation of the service user’s pathway from application to cessation.”
Separately, a Department of Health spokesperson told MI that the Health (Amendment) (Home Support Providers) Bill 2025 will introduce the registration and regulation by HIQA and the Chief Inspector of Social Services of all home support providers in Ireland.
The Chief Inspector will also monitor and assess compliance of registered home support providers against regulations and HIQA standards. “The Bill was published in December 2025 and has now completed second stage in the Dáil and has been referred to the select committee on health.”
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