Health and social care data and the Hippocrates model: Gaps and recommendations

Executive Summary

Health information has an essential role to play in health and social care planning decisions. Traditionally, Ireland lagged behind its European peers in prioritising health data, with several instances of health and social care data either not being recorded, or being recorded and stored but in a manner that prevents their use for planning purposes, or not being easily accessible to those who require it. While investment in this area has increased rapidly in recent years, data and health information deficits continue to impact a range of stakeholders across the health system. This report identifies and discusses data gaps in the Irish health and social care sector, with particular reference to the data required to project future demands for health and social services within the ESRI Hippocrates model. The report focuses on the availability of data – along with notable gaps – in 2024/2025, when the Hippocrates model was most recently updated. Within this context, it is important to acknowledge that several significant data developments are currently underway, which have the potential to transform health data availability in the Irish context; these include the Digital Health Strategic Implementation Roadmap, the Health Information Act 2026 and the European Health Data Space.

Several major data issues in the Irish context limit the amount and type of analysis that can be undertaken to inform health system planning and reform in Ireland. These include:

1. incomplete and inconsistent use of an Individual Health Identifier (IHI);
2. incomplete and inconsistent use of electronic health records (EHRs);
3. incomplete data on privately provided/financed services;
4. incomplete data on primary care and community-based services; and

5. incomplete data at the Health Region level.

    

A number of ongoing initiatives seek to address these limitations, which when implemented will significantly improve data infrastructure and availability. In this context, consideration is required from the outset regarding how data collected through ongoing initiatives can and should be used for purposes beyond immediate patient care, including research and service planning. Drawing on recommendations from the World Health Organization (WHO), it is recommended that the sharing of data for research purposes should be done in a manner that is equitable, ethical and efficient, including initiatives such as the Trusted Research Environment.

In 2025, the ESRI published six reports, which included projections of demand and associated capacity requirements, at both the national and HSE region level for public acute hospitals, general practice and older people’s services. While these analyses included the most up-to-date, available data at the time of completion, the extent of the analysis that could be undertaken for each service area was significantly curtailed by data availability.

• Public acute hospitals: The best available data among the services examined are for the public acute hospital system and, in particular, for day patients and in-patients using the Hospital In-Patient Enquiry (HIPE) scheme. However, there are limitations to these data. For example, the incomplete and inconsistent use of the IHI means that the analysis is at the discharge level rather than the patient level. Consequently, a key recommendation is the enhancement of HIPE as a patient‑level dataset; further, there are more limited data available on other hospital based services, including emergency departments (EDs) and outpatients; these services would benefit from a patient-level HIPE-type dataset.
  
  
• General practice: There are limited administrative data available on general practice in Ireland. Consequently, the projection analysis relied on survey data, which have inherent limitations, including recall bias and the exclusion of consultations for certain population groups, including those living in communal establishments and who are homeless. This report recommends the development of a regularly updated, centrally held administrative dataset on general practice with a core set of variables. Such a dataset could include information on the general practice workforce and working hours, as well as appropriately anonymised individual level data capturing variables such as age group, sex, medical card status and number of consultations of those registered with a practice.
   
• Older people’s services: While there are some administrative data available on older people’s services (in particular long-term residential care (LTRC) and home support), it is limited in nature and needs to be supplemented with survey data for the Hippocrates projection analysis. As with general practice, this report recommends the development of a minimum dataset of LTRC residents and home support recipients in Ireland, which would include details for example on age, sex and dependency levels. Further, there is a need for data on other services used by older people, including Meals on Wheels and respite care.
  
  

Arising from the Digital Health Strategic Implementation Roadmap, the Health Information Act and the European Health Data Space, a wide range of initiatives aimed at strengthening the health data infrastructure and availability are currently underway. While some developments are at a more advanced stage than others, full implementation will take time. It is now essential to consider how these initiatives will operate in practice, particularly in relation to how data can be shared beyond immediate clinical care settings. In the meantime, other initiatives could significantly enhance data availability for planning, policy and research purposes. It is vital that improvements to the health data focus not just on publicly provided care, but also on the extensive care provided by voluntary and private providers, much of which is publicly funded.