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Preparation of ‘shadow budget’ for population-based resource allocation

By David Lynch - 08th Feb 2026

population-based
Credit: istock.com/porcorex

The full implementation of population-based resource allocation (PBRA) across the six health regions will take place in 2027, following the creation of a PBRA ‘shadow budget’ this year, the Medical Independent (MI) has been informed.

The issue was discussed at the Sláintecare programme board meeting in September 2025.

Members noted that the PBRA expert group is meeting regularly to develop and agree the methodology applicable to PBRA in 2027.

The expert group was established in 2024. According to the Department of Health, its role is to develop and agree on the methodology and approach for implementing PBRA within the health service.

The goal of PBRA is to “ensure a fair and equitable” distribution of healthcare funding to the six health regions based on population health needs and the cost of providing services to meet those needs.

The PBRA approach focuses on demographic indicators and non-demographic indicators such as deprivation and distance to services.

“As in other countries, PBRA implementation will be a multi-year, iterative process, and the work of the expert group will be ongoing,” a Department spokesperson told MI.

The spokesperson said that a “shadow regional budget”, based on population demographics, is being prepared for 2026, in preparation for full implementation of PBRA in 2027.

The spokesperson said that the shadow budget means that this year each region “will receive their funding allocation as per the process in the previous year [2025], but will also be provided with the details of how a population-based budget would look on the basis of demographics”.

“This allows regions to monitor spend against both actual budget and shadow budget over the course of the year. It also allows the Department to receive feedback on how well the model performed or make any adjustments that might be required before being implemented in 2027.”

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