You've come to the right place to understand Domiciliary Care services in Europe and Emerging Markets. Here is how we can help you:
Detailed research report on Domiciliary Care services with marketshare and growth rates for 13 countries and information on a further 211 (HBI Intelligence)
Database of 211 Domiciliary Care service providers, including profile and major external investors (HBI Intelligence)
Merger and acquisition (M&A) intelligence showing likelihood of sale (HBI Intelligence)
News stories and interviews with Domiciliary Care operators (HBI Deals and Insights)
Events that cover healthcare services globally including Domiciliary Care (HBI 2024)
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Sector ReportDomiciliary Care Sector
Updated: February 2024
Executive Summary
EXECUTIVE SUMMARY
Impact of Covid-19
We are in the process of analyzing the impact of Covid on the care sector and we should have updates for every country’s growth forecasts for 2020 and 2021 by end of May. There has been a strong short-term impact with costs rising and demand falling which we have already reported in news. A serious recession may further hit demand and tariffs and leave many investors breaking their bank covenants.
Methodology & definitions
In this report, we define domiciliary care services as the paid provision of unskilled assistance with personal hygiene, cooking, domestic chores and social activities for older and disabled people. As it is paid, we are excluding from our definition all help given within family and friend networks.
In general, many markets are dominated by not-for-profits (Netherlands, France and Italy). The for-profit sector operates either for public payors or for out of pocket payments.
Drivers
“The biggest opportunity in the care market in general is the ageing population,” says Jorg Veil, managing director of Home Instead Germany. According to the United Nations, people aged 65+ outnumbered children under five for the first time in history in 2018, and the number of people aged 80+ is set to triple by 2050.
Domiciliary care presents itself as a viable and attractive alternative to nursing homes for people with increasing dependence needs who want to live at home. Many of the biggest nursing home chains are now providing domiciliary care as an additional business stream, as are many medicalised homecare players, securing clients further up the care path before they opt into residential or more intensive care down the line.
Scope for growth & consolidation
Domiciliary care is still considered a Cinderella sector where most national markets remain undeveloped. The major for-profit players have tiny market shares.
We can see several types of players. There are the big European nursing home groups who are building domiciliary care arms, pure domiciliary care players, and franchising groups, including US’s Home Instead who are expanding across Europe. There are also large groups such as City & County Healthcare Group in the UK which are mainly working on very low margins for local authority public payors.
A few online Uber-style operators are emerging in Spain, France and the UK such as Soomville! or Hoper in France. So far, they appear to have had little impact.
Opportunities
The potential for domiciliary care across Europe has yet to be fully tapped. There are large addressable markets, the largest being France and Germany, where plentiful demand and a preference for domiciliary care over nursing homes plays into the sector’s favour.
In the UK, a large and fragmented market of small providers is poised for consolidation.
Challenges
The sector faces huge headaches - low margins, staff shortages and informal competition.
Staff shortages are recorded across Europe, especially in the UK where Brexit is expected to affect recruitment from abroad and will restrict the growth of the sector if solutions are not found. All providers we have spoken to cite such shortages as the biggest challenge to business. Some providers, such as SunaCare and Promedica-24 in Germany, have based business on sourcing unskilled carers from Eastern Europe to fill the gap. Legislation in Germany is underway to make this easier, but in the long-term this will drain workforce abroad, so sustainable solutions need to be found.
The good news is that many governments are implementing wide-reaching budgetary changes, as well as labour, education and healthcare reform which will hopefully go a long way to solving the problem. The NHS’s long-term plan has made community-based care a priority and providers expect this to show in council budgets. In France, a law passed in 2015 allocated further funding to the sector and has pushed for an increase in the hours of care.
Sample report pages and data
What we offer
- Instant overview of the EMEA domiciliary care market and players This report gives you visibility of this important, fast-growing market across 7 countries with market data on all, as well as detailed profiles of the Top 50 players.
- Ever green! Updated throughout your subscription As part of our HBI intelligence platform this report is updated throughout the period of your subscription. You will also receive additional news stories and interviews on domiciliary care throughout the period.
- Insights on business models The report is based on in-depth interviews with many operators. The report also looks at how domiciliary care players can best build customer loyalty.
- Identify national opportunities We assess opportunities at national level based on the regulatory environment and proposed reforms.
- Size markets This report enables you to swiftly see market sizes and market shares
- Save time and money This report will save you weeks researching these opaque markets and enable you to swiftly identify investment opportunities, new partners and markets.
Table of Contents
Table of Contents
EMEA overview
Datasets Size of EMEA market 2018 Marketshare of major EMEA players 2018 Comparison of market sizes 2018 Comparison of market growth rates 2016-2020
Methodology & definitions
Definitions from several different countries
Provider types
Drivers - Ageing population - An alternative to nursing homes
Scope for growth & consolidation
- Nursing homes developing domiciliary care arms
- Franchising groups
- “Uber”-style operators
Opportunities
- Large and fragmented markets - Franchise opportunities
Challenges
- Low margins
- Staff shortages
- Good news: government wide-reaching budgetary changes
France
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Germany
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Ireland
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Italy
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Netherlands
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
Spain
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
United Kingdom
Data sets For-profit /private market size and growth rates 2016-2020 Marketshare of major players 2018
Market description and trends.
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Domiciliary Care News & Interviews
Our indepth stories dig deep and cover profit multiples, revenue, EBITDA and CEO thinking.
The centre of gravity of the health and care sector is shifting away from hospitals and nursing homes. Capacity and resource constraints combined with policy pushes for greater access in the community and advances in medtech mean that over the coming decades a...
The UK’s care sector has become heavily dependent on foreign nations for its healthcare workforce. With new proposals from the Home Office restricting whether families can accompany some workers coming to the UK, HBI speaks to two operators to hear what impa...
A shortage of high-quality healthcare workers in Europe is causing countries to recruit from a more global pool. The Danish government is partnering with India and the Philippines, and HBI hears LATAM could be the new hotspot from which foreign workers will be...
As the threat of mass bankruptcies hits the headlines in Germany, HBI hears that residents are beginning to feel the sting of the country’s dwindling supply of nursing homes, and that 2024 could prove to be the tipping point when public pressure actually tri...
This week, the UK’s Home Secretary James Cleverly announced government plans to tighten health and care worker visas. HBI speaks to a global workforce expert to understand what this attempt to prioritise ‘British talent first’ will mean for operators alr...
UK Homecare group Optimo Care is acquiring specialist supported-living provider Abbeycare, the deal marking the group’s eighth acquisition in the last year. HBI speaks to Ben Hales, Optimo’s group project director to find out more about its run of M&A in w...
Anyone can put up a building. The key is staffing it with the right people, particularly in health care. This means the next decade will see the rise of new people-centric models and the demise of businesses that rely on more traditional employee/employer relat...
This summer, a new immigration reform was passed to make it easier for workers from non-EU countries to relocate to Germany. An Indian organisation plans to train 2,000 nurses for the German market. HBI speaks to experts to find out who will make the most of t...
In a bid to compete with temporary agencies, elderly care staff in the Netherlands as set to receive salary hikes of 5% this October - with another 5% increase again in 2024. HBI speaks to one Dutch sector expert to understand the reasoning behind the move and...
Database of 211 Domiciliary Care service providers
HBI has built a unique database of the Top 4,000 operators globally in health care services. As part of this, we have identified the top 211 Domiciliary Care operators in Europe and will soon add the major players in Emerging Markets.
Profiles include revenue/sales data as well as EBITDA and other profit margins where known. They also cover private equity ownership with dates and mergers and acquisitions.
Mergers & Acquisition (M&A) Intelligence
Our deal pipeline shows how likely all private equity and some privately companies are to sell based on algorithms and journalistic know-how.
HBI 2024 – the only CEO-level conference to cover healthcare services globally
HBI 2020 – the only CEO-level conference to cover healthcare services globally
In 2019 this event brought together 700 delegates from over 40 countries. Over 60% are CEO level and they included 150 specialist investors in health care services. HBI 2020 includes a panel discussion on domiciliary care, with panelists from a range of operators and a range of countries, including Romania, Germany and Israel.
Other sessions look at trends in the investment and merger and acquisition, digital health and telehealth.
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