How resilient and sustainable is the Irish healthcare system?

Trinity researchers believe we need to better understand how to build resilience, in a sustainable way, ensuring the Irish health system is prepared for subsequent economic, climate, health or political crises. 

A study to examine our healthcare system’s sustainability and resilience launches today.Trinity researchers from the Centre for Health Policy and Management, School of Medicine have collaborated with the global Partnership for Health System Sustainability and Resilience (PHSSR) to ensure our health system is able to continually deliver its functions over the long-term, whilst also being able to prepare for, adapt to, learn, transform and recover from shocks and accumulated stresses. The Trinity research team will examine the Irish system, but the partnership is carrying out this study in 20 countries around the world.

Pre-pandemic, many healthcare systems around the world were struggling to contain costs and meet demand amid aging and growing populations and rises in non-communicable diseases along with workforce and other challenges. COVID-19 further worsened these issues and starkly exposed weaknesses in health systems. Ireland has not been immune to these challenges. It has capacity problems and long waiting lists, and is one of the few European health systems without an entitlement to Universal Health Care.

The Partnership for Health System Sustainability and Resilience (PHSSR) is a global collaboration between academic, non-governmental, life sciences, healthcare and business organisations. The PHSSR and its partners seek to work with local academics, governments, policymakers and other stakeholders like providers and payors to build knowledge and guide action through research reports that offer evidence-informed policy recommendations to improve healthcare system sustainability and resilience.

This study is of particular importance as Ireland emerges from this pandemic while also engaged in an ambitious programme of reform (Slaintecare) and having only relatively recently emerged from a prolonged period of austerity that pushed the health system to its limit.  Researchers believe we need to better understand how to build resilience, in a sustainable way, ensuring the Irish health system is prepared for subsequent, economic, climate, health or political crisis.

Trinity is the only Irish academic institution involved in this collaboration but are involving stakeholders in an advisory capacity from the Department of Health, Department of Finance, Health Service Executive (HSE), Irish College of General Practitioners (ICGP), Economic Social and Research Institute (ERSI), Tampere University (Finland), and Personal and Public Involvement (PPI) representatives. This research is funded through the HRB-funded RESTORE project.

By collaborating with academic, industry and government partners, in a timely and responsive manner, the PHSSR project allows for opportunities to quickly translate evidence into policy and practice in real time. The Trinity team will use a framework developed by the London School of Economics to assess the country’s health system[s] across seven key domains; financing, governance, workforce, medicines and technology, service delivery, population health, and environmental sustainability, in order to identify strengths, potential weaknesses, opportunities and risks. A report will then be developed and validated with input from a cross-sectoral group of expert stakeholders.

Results of the PHSSR research report in Ireland are expected to be released in September 2022. These findings will also be presented to a global audience at PHSSR’s second Global Summit, planned for late 2022.


Professor Steve Thomas, (pictured above)Edward Kennedy Chair of Health Policy and Management and the Director of Health Policy and Engagement for the School of Medicine, said:

The RESTORE PHSSR collaboration is an exciting initiative drawing together expertise from an HRB Research Leader Project and a global research programme. It will evaluate available evidence on health system resilience and sustainability to highlight lessons from COVID-19 as we face future shocks. The collaboration is an innovative partnership of public and private collaborators drawing expertise from a broad range of academic, government and industry stakeholders.

The research will compile, analyse and reflect on data from available system metrics and key informant interviews. This will bring a rounded picture of our health system response to COVID-19 and how we can face long-term challenges. Shocks, while presenting a massive challenge to health systems, can give rise to opportunities for learning, change and investment.


Professor Alistair McGuire, Head of Department and Chair of Health Economics at the Department of Health Policy, London School of Economics, said:

The PHSSR is grasping the opportunity the pandemic has given us to act and address global health issues. We are turning research into action by working with over 20 countries to identify solutions with the greatest potential, support their adoption, and share knowledge across borders.