The Northern Ireland Health and Social Care (HSC) workforce has grown to 68,341 whole-time equivalent staff as of March 2026, according to new statistics published by the Department of Health. While overall staffing has expanded by more than 2 per cent over the past year, vacancy numbers have climbed to more than 6,200 posts actively being recruited, raising questions about whether recruitment can keep pace with growing demand.
The latest quarterly figures reveal a system under pressure, with nursing and midwifery posts accounting for nearly one-third of all vacancies. The data highlights significant regional variations, with some trusts seeing vacancy rates surge by more than 20 per cent while others report declines.
Workforce Growth Continues
At 31 March 2026, the HSC workforce stood at 68,341 whole-time equivalent (WTE) staff, representing an increase of 2.2 per cent (1,476 WTE) from March 2025 and an 8.1 per cent rise since March 2021. The figures cover hospital, community and social services staff across Northern Ireland’s five regional trusts and other HSC organisations.
Nursing and midwifery remain the backbone of the workforce, comprising one-third (33.3 per cent) of all staff at 22,776 WTE. Within this group, registered nursing and midwifery staff increased by 3.1 per cent (562 WTE) to 18,612 WTE over the past year. However, nursing and midwifery support staff numbers fell by 1.3 per cent (55 WTE) to 4,164 WTE.
The Belfast HSC Trust continues to employ the largest share of staff, with 19,499 WTE—2.4 per cent higher than the previous year. All five regional trusts reported workforce growth compared with March 2021 figures.
Staff turnover shows a joining rate of 8.5 per cent against a leaving rate of 6.3 per cent for the prior year. Over one-third (37.4 per cent) of the workforce now work at Agenda for Change pay bands 6 and above, while 32.4 per cent are in bands 1–4.
Vacancies Climb to 6,236 Posts
Despite workforce growth, the number of vacancies actively being recruited across the HSC rose to 6,236 at March 2026—up 6.6 per cent from the 5,851 vacancies recorded a year earlier. This represents an active recruitment vacancy rate of 7.2 per cent.
The Nursing and Midwifery occupational family recorded the highest number of vacancies at 1,960 posts, accounting for 31.4 per cent of all vacancies in recruitment. This comes amid a UK-wide slowdown in international nursing recruitment, with the Nursing and Midwifery Council reporting an almost 50 per cent collapse in overseas professionals joining the register in recent months.
Regional disparities are stark. The Belfast HSC Trust had the highest number of vacancies (1,733), while the Northern HSC Trust saw the greatest annual percentage increase at 20.9 per cent. The Western Trust followed with a 13.1 per cent increase. Only the South Eastern HSC Trust bucked the trend, reporting a 5.5 per cent decrease in vacancies.
Missing Pieces in the Data
The statistics exclude several significant groups that affect the true picture of workforce pressure. Bank and sessional staff—who fill critical shortfalls to maintain service delivery—are omitted, as are domiciliary care workers. The Department notes this is because “their recorded whole-time equivalent currently does not reflect their contribution to the service.” Staff on career breaks and board members are also excluded.
Furthermore, the vacancy figures only capture posts “actively being recruited to” and do not include positions that may be unfilled but not currently in recruitment, or those temporarily on hold by managers.
Policy Context and Pay
The publication of these statistics comes as the health service awaits confirmation of a 3.3 per cent pay award for 2026/27, recommended by the NHS Pay Review Body but pending NI Executive budget confirmation. Health Minister Mike Nesbitt has committed to proceeding with the uplift, though formal confirmation may follow the pattern of previous years when awards were announced months after the April start date and paid with back pay.
The figures also provide a baseline against which to measure future safe staffing legislation. A consultation on Safe and Effective Staffing legislation closed in October 2024, with the Department committed to expanding scope beyond nursing to cover all professional disciplines. Launching that consultation, Minister Nesbitt said: “The most crucial component in our health and social care system is the dedicated and skilled workforce. Without our workforce, this system would cease to function and put people’s lives at risk. The people of Northern Ireland rightly deserve a first-class healthcare system.”
Questions for Stakeholders
- Why does the South Eastern Trust continue to reduce vacancies while other trusts see double-digit increases, and what lessons can be shared?
- With international nursing recruitment collapsing by nearly 50 per cent, how will the system fill the 1,960 nursing vacancies currently advertised?
- When will the Safe and Effective Staffing legislation be introduced to Parliament, given the consultation closed eight months ago?
- How does the exclusion of bank and domiciliary staff from official statistics affect workforce planning and the true measurement of staffing pressures?
- Will the proposed 3.3 per cent pay award be sufficient to improve retention given the 6.3 per cent leaving rate, and when will it be formally confirmed?
Looking Ahead
The data reveals a health service growing its permanent workforce but struggling to fill vacancies fast enough. With the Northern Trust reporting vacancy growth of nearly 21 per cent and nursing shortages persisting across all regions, the challenge now shifts to retention and recruitment. The coming months will reveal whether delayed pay awards and potential safe staffing legislation can reverse the vacancy trend, or whether the gap between workforce supply and demand will continue to widen.
The full statistical publications are available via the Department of Health website: workforce statistics and active recruitment statistics.