Domiciliary Care sector across EMEA

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 8 countries and information on a further 129 (HBI Intelligence)
  • Database of 129 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 2020)
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Sector Report
Domiciliary Care Sector

Updated: October 2020

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.


“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.


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.


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
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
                                    - Ageing population
                                    - An alternative to nursing homes
Scope for growth & consolidation
-       Nursing homes developing domiciliary care arms
-       Franchising groups
-       “Uber”-style operators
                        - Large and fragmented markets
                        - Franchise opportunities
-       Low margins
-       Staff shortages
-       Good news: government wide-reaching budgetary changes
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
Market description and trends.
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
Market description and trends.
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
Market description and trends.
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
Market description and trends.
Data sets
For-profit /private market size and growth rates 2016-2020
Marketshare of major players 2018
Market description and trends.
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.

Domiciliary Care News & Interviews

Our indepth stories dig deep and cover profit multiples, revenue, EBITDA and CEO thinking.

199 news stories on Domiciliary Care.

Ambea Q1 points to slow recovery for Nordic social care 43h ago

Recovery in the Nordic social care market is happening slower than expected as provider Ambea expects a hit on revenues and profits in Q1 to continue in the second quarter. Sweden has been particularly badly hit with EBITA down in both its elderly care and dis...

Growth picks up in Spanish homecare post-COVID 1w ago

Spanish homecare is returning to pre-pandemic double-digit growth after a flat 2020, HBI hears from Asisted, a Spanish homecare operator. ...

Job-hopping puts Germany’s live-in care market at risk 2w ago

Live-in carers in Germany are favouring short-term contracts and regularly switch employer. HBI speaks with Benedikt Zacher, senior strategist at Berlin-based SunaCare, to find out why this is a problem....

Union pressure mounts as French domiciliary care reform looms 2w ago

French Minister for Autonomy Brigitte Bourguignon says "Amendment 43", which would see compulsory wage rises for public domiciliary homecare workers, has the governments full backing. For profit operators have expressed concern, but unions in France are calling ...

Unicare founder furious after ousting 3w ago

London-based private equity fund G Square Capital has taken full control of private health and care group Unicare. Founder and minority shareholder Tom Tidemann tells HBI he is dismayed by its action - but G Square's CEO tells HBI it was necessary to stop Unica...

Why UK homecare lags behind nursing homes in tech-assisted care 3w ago

Technology-assisted homecare in the UK remains nursing homes' poor relation, despite the potential to reduce the live care needed and solve understaffing issues. HBI speaks to multiple tech experts and asks why it hasn't caught on in the same way....

Cera Care strives to hit recruitment target 3w ago

In March last last year, the UK homecare group Cera Care said it would create 10,000 new jobs for carers across the country in response to COVID. More than one year on, HBI understands that less than 40% of these prospective vacancies have been filled so far, ...

Norway moves to increase patient choice 4w ago

The Norwegian government is trying to introduce more free choice for patients, particularly when it comes to elderly care, with a new procurement framework. The move comes after a few years of Norwegian municipalities refusing to work with the for-profit secto...

Domiciliary care flatlines in Sweden 1mo ago

The Swedish domiciliary care sector did not enjoy the same growth as its European neighbours through the pandemic, with older residents rejecting all but the most essential services. HBI speaks to two Swedish domiciliary care operators to find out more....

Database of 129 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 129 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 2020 – 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.  
Contact us in the UK on 0207 183 3779 for more information.