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 11 countries and information on a further 130 (HBI Intelligence)
  • Database of 130 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: June 2021

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.

213 news stories on Domiciliary Care.

EMEA's Top 100 largest groups by revenue revealed 6d ago

HBI’s inaugural HBI Health Care Services Top 100 lists the largest 100 companies by EMEA health care services revenue. In total revenue their revenue came to over €105bn - and we've uncovered some surprising winners and losers. ...

UK domiciliary care workforce surges during pandemic 2w ago

UK domiciliary care providers are seeing a rise in caregiver jobs, job applications, and hires driven by COVID. As lockdown lifts, HBI examines what is happening in the market....

Irish HomeCare to grow its workforce two-fold 1mo ago

Irish HomeCare has announced a plan to recruit 700 new care workers and 50 full time office staff in the next 18 months, responding to a surge in demand for homecare. If it achieves the target it will double its workforce. HBI speaks John Florence, CEO of Iris...

KCP exits specialist homecare group Routes 1mo ago

Private Equity firm Key Capital Partners (KCP) has sold its majority interest in long-term homecare operator Routes Healthcare, through a secondary buy-out backed by Palatine Private Equity. ...

Interview: Ray Berglund and Dominic Orchard, Alvarez and Marsal 1mo ago

The pandemic is causing many businesses and their investors to reassess their plans - and their portfolios. HBI speaks to Ray Berglund, Head of European Healthcare and Life Sciences at management consultants Alvarez & Marsal, and his colleague and Managing Dir...

Investors looking south of the border as NI homecare struggles 2mo ago

Low pay rates for homecare workers in Northern Ireland are under fire, and a campaign to end short 15-minute visits for older people and fee rates of £15 an hour is gathering momentum. South of the border the Republic is proving far more attractive to investo...

Hancock's perilous position a problem for the NHS 2mo ago

The future of the UK NHS is changing according to the recent White Paper and Queen's Speech - we're moving towards collaboration not competition and a Secretary of State for Health with wider powers. But current incumbent Matt Hancock's reputation is damaged and ...

How much of Europe's homecare is ‘grey’? 2mo ago

This week HBI breaks down data from several sources and illustrates the share of informal homecare in European Countries and the UK. It makes clear just how much care at home is being illegally delivered....

German government increases care worker pay and working conditions 2mo ago

The German government is to legislate an increase in care worker pay, and improve conditions. HBI speaks to a Berlin-based operator to find out more - including why the move has not been universally welcomed....

Database of 130 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 130 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.