GP service demand facing significant increase
Demand for general practice services will rise sharply over the coming two decades, requiring between 24 and 31 per cent more GPs and 33 to 38 per cent more general practice nurses (GPNs) by 2040, according to research published by the Economic and Social Research Institute (ESRI).
The report, released in June 2025, provides the most up-to-date national projections of activity and workforce needs in general practice. Using the ESRI’s Hippocrates model, researchers estimate that GP consultations will grow by between 23 per cent and 30 per cent, while GPN consultations will increase by between 32 per cent and 36 per cent. The projected increase is driven primarily by population growth, an ageing demographic profile, and recent policy reforms expanding access to care.
These findings underline substantial capacity challenges for primary care services and highlight the need for long-term strategic workforce planning.
Rising population and ageing
Ireland’s population has grown more rapidly than expected in recent years, due in large part to high inward migration and increased life expectancy. Under the ESRI’s central scenario, the State’s population is expected to grow by 900,000 people by 2040, with particularly sharp increases in older age cohorts.
General practice is especially sensitive to demographic change. Consultation rates rise significantly with age, and attendance among children under the age of six is also comparatively high. The ESRI estimates that population growth alone will account for the majority of increased demand, with population ageing contributing a further substantial share.
“A growing and ageing population is the dominant source of future pressures on general practice services,” the authors state, adding that demographic forces are “structural, predictable, and largely unavoidable”.
Reshaping demand
While demographic change is the primary driver, recent policy reforms have also increased, and will continue to increase the volume and complexity of work in general practice.
Three developments are particularly influential:
1. Expansion of free GP care: In 2023, eligibility for GP visit cards was widened significantly, including automatic entitlement for children aged six and seven and increased income thresholds. This expansion added roughly 500,000 eligible individuals. Uptake assumptions in the ESRI projections indicate that newly eligible groups will use GP services at rates similar to existing cardholders, further increasing consultation volumes.
2. Growth of the Chronic Disease Treatment Programme (CDTP): The CDTP, which aims to manage chronic conditions such as diabetes, COPD, asthma, and cardiovascular disease within general practice, has seen strong uptake: 83 per cent of eligible patients over the age of 65 had enrolled within two years. Each enrolled patient requires a minimum of four structured consultations per year (two GP and two GPN). This adds substantial workload, although the ESRI notes that effective chronic disease management may reduce unplanned or acute attendances in the longer term.
3. System-level reforms under Sláintecare: Sláintecare’s ambition to shift care from hospitals to the community will further increase the scope and intensity of general practice services. While these reforms are ongoing, the authors highlight that much of this change is occurring “in a data vacuum”, complicating accurate forward planning.
Projected consultation volumes
Using the Hippocrates model, the ESRI forecasts:
- GP consultations: +23 per cent to +30 per cent by 2040
- GPN consultations: +32 per cent to +36 per cent over the same period
GPN services are projected to grow faster due to increased involvement in chronic disease management, childhood vaccinations, preventive services, and care for older populations.
These projections reflect a range of scenarios drawn from assumptions on population growth, eligibility uptake, healthy ageing, and CDTP participation.
Data gaps
A consistent theme throughout the report is Ireland’s lack of comprehensive, nationally representative data on general practice activity. Most existing utilisation data comes from surveys, which cannot capture the totality of GP work, including out-of-hours activity or practice-level variation.
This limits the State’s ability to monitor shifts in demand, evaluate reforms, and plan effectively.
The authors recommend prioritising robust data collection systems in general practice, including consistent reporting on consultations, workforce activity, and programme participation.
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Workforce implications General practitioners (GPs)
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Policy considerations
The ESRI identifies a series of policy implications arising from its findings:
1. Substantial expansion of training pipelines: The report says that while GP training places have increased in recent years, the projected scale of demand raises questions about whether current expansion plans are sufficient. A long-term strategic workforce plan is required to align training output with projected need.
2. Enhanced roles for GPNs and practice staff: The report suggests that broader deployment of GPNs, health assistants, practice managers, and allied health professionals could help absorb rising demand, particularly if GP consultation capacity becomes constrained.
3. Sustainability of expanded benefits: The broadening of free GP care significantly increases workload. The sustainability of these benefits must be considered alongside workforce growth and practice capacity.
4. Chronic disease management in community care: Given the scale of chronic disease, the ESRI highlights the need for resourcing and system design that supports stable, long-term management in primary care settings.
Responding to the report, Minister for Health Jennifer Carroll MacNeill TD says: “The report will make an important contribution to our work in increasing the supply of GPs, GP nurses, and other staff essential to general practice over the next 15 years. The report highlights the challenge we face in ensuring that our population continues to have access to quality GP services.
“The ongoing Strategic Review of General Practice, due to complete its work this year, will outline new ways to ensure we have the capacity to provide essential GP services.”
